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MCB 135K – Mid-Term II Practice Exam March 30, 2004 I. Multiple choice questions, only one (the most appropriate) answer is correct. 1. The following are morphological changes that occur in the brain of healthy (non affected by CNS neurodegenerative diseases) elderly individuals, EXCEPT: A. Intracellular accumulation of lipofuscin B. Intracellular accumulation of neurofibrillary tangles C. Intracellular accumulation of neuritic plaques D. Dendritic and synaptic losses E. Extracellular accumulation of neuritic plaques 2. Dementia (from the Latin de-mentis, without mind) presents these characteristic symptoms, EXCEPT: A. Loss of all cognitive functions B. Loss of consciousness C. May be of the Alzheimer type D. May be of the multi-infarct type E. Persistence of consciousness 3. Which of the following is NOT an anti-oxidant/free radical scavenger? A. Superoxide dismutase (SOD) B. Ascorbic acid (vitamin C) C. LCAT D. Lipoic acid E. Vitamin E 4. Which of the following shows the largest age-related decline in visual function? A. Glare sensitivity/Glare recovery B. Flicker sensitivity C. Standard visual field D. High contrast acuity E. All of the above 5. Choose the answer that best describes how the lens contributes to changes in visual function with age. A. Increased light scatter causes glare sensitivity B. Yellow pigment accumulates, affecting color perception C. Diameter decreases in size, reducing night vision D. A + B E. A + C 6. How does functional MRI measure changes in brain activity? A. Monitors local temperature B. Detects electrical activity C. Scans for changes in blood circulation D. Staining for neurotransmitter release E. All of the above 7. How do the various enzymes and cell surface receptors that recognize lipoproteins distinguish one type of lipoprotein from another type? (VLDL versus HDL, for example) A. Density B. Size C. Surface apolipoproteins are unique D. Location E. A + B 8. Which of the following lipoproteins has the highest density and the smallest size? A. Chylomicrons B. LDLs C. VLDLs D. HDLs E. IDLs 9. Localized factors contributing to atherosclerotic lesions include: A. Marginal vascularization of the arterial wall B. Relative ischemia (insufficient blood supply) C. Blood turbulence and mechanical stress D. All of the above E. None of the above 10. When the capsule of the atheroma breaks away: A. The plaque is transformed into an ulcer (break of intima with loss of endothelial cells) B. Blood clots (thrombi) are formed on the ulcerated surface C. The blood clots may break away from the arterial wall, break down into circulating emboli that may block small arteries distant from the side of thrombus formation D. The arterial wall is weakened and the artery may rupture as in the aneurysm and hemorrhage E. All of the above 11. The old adjectives that used to qualify atherosclerosis are still valid EXCEPT: (Atherosclerosis is…) A. Universal B. Progressive C. Irreversible D. Functionally deleterious 12. The endothelial cells of the intima have very important functions in maintaining the plasticity of the arterial wall and the fluidity of the blood. With aging: A. The imbalance of vascular tone is manifested by increased vasodilation B. Cell proliferation for repair is increased C. Maintenance of blood fluidity is disrupted D. Blood coagulation and thrombosis are increased E. C and D 13. Major risk factors for Coronary Heart Disease, include the following, EXCEPT: A. Age B. Hypertension C. Diabetes D. Obesity E. Low blood levels of homocysteine 14. Which statement is FALSE? A. with aging the repertoire (diversity) of leukocytes shifts B. bone marrow contains stem cells from which all lymphocytes are derived C. clonal deletion is a function of the thymus D. natural killer cells prevent autoimmune disease 15. Which statement is FALSE? A. plasma cells differentiate into B-cells which secrete large quantities of highly specific antibody. B. The CD-4 receptor is found on T-helper cells. C. There is a good correlation between Natural Killer cell number and longevity D. Viral antigens are expressed and associated with MHC I receptors on infected cells. 16. Which statement is TRUE? A. With aging antibody production increases B. With aging immune protection from bacterial infections is increased C. T-cells can differentiate into B-cells. D. The number of B cells is decreased 17. Which statement is FALSE? A. Thymic epithelial cells secrete thymosins B. Ig E is involved in allergic responses C. The thymus becomes enlarged with aging D. Thymosins are important in the differentiation process of T-cells 18. Which statement is FALSE? A. IgM is often secreted by plasma cells during a primary immune response B. There is an increased concentration of autoantibodies in blood with aging C. Complement factors play an important role in clonal deletion of Tcells D. There is a decline in the production of new cells from bone marrow with aging 19. Which statement is FALSE? A. With aging B cells and T cells fuse more frequently B. With aging there is often a decline in responsiveness to vaccinations C. With aging, there is an increased production of self antigens D. Wth aging there is an increase in pro-inflammatory cytokines. 20. Sarcopenia, or loss of skeletal muscle mass, may be due to all the following factors, EXCEPT: A. Reduced physical activity B. Loss of peripheral motor nerves C. Reduced muscle protein synthesis D. Decreased number of circulating red blood cells E. decreased mitochondrial mass II. True/False Questions TRUE: A FALSE: B (Mark on Scantron) 22. T/F Acetylcholine, norepinephrine, serotonin, and glutamate are major neurotransmitters in cerebral synapses 23.T/F Neuron loss with aging is universal (occurs in all brain areas) 24. T/F Free radicals are capable of initiating a chain reaction of oxidation events 25.T/ F Endothelial derived relaxation factors (ERRFs) promote hypertension 26.T/ F Good blood cholesterol is indicated by low serum HDL and high serum LDL 27. T /F Poor diet and lack of exercise is one of the leading causes of death in the U.S. 28. T /F Macrophages recognize oxidized lipids by the scavenger receptor 29.T/ F Denudation is the process of neuron dendrite formation 30. T /F Reactive oxygen species (ROS) are generated by all aerobic organisms III. Short Answer Questions 31) The observations that (1) antioxidants FAIL to extend rodent life span and (2) chronic low-level ionizing radiation DOES extend rodent life span appear to contradict the free radical theory of aging. Explain each of these two contradictory observations by invoking the hypothesis of “compensatory homeostasis” 32. List four reasons why free radicals are so harmful (reactive)? 33. List 3 among the most frequent cardiac diseases in the elderly: 34. Mention 2 of the signs of Right Heart Failure: 35. Standard visual field does NOT decline with age, however, attentive visual field DOES decline with age. Based on Dr. D’Esposito's lecture on imaging the aging brain, how might changes in brain function result in the loss of attentive visual field with age? Specifically: 1) What type of brain function decreases with age? 2) What area of the brain is affected? 3) How might this reduce attentive visual field? 36. Sarcopenia may occur under several conditions, one being old age. a) List 3 major changes, structural or functional, that characterize the muscle (including the myoneural junction) of the elderly. b) Disuse muscle atrophy is another type of sarcopenia that may occur at all ages. Explain what it means: Is it reversible/irreversible? Give an example of one condition that leads to disuse atrophy.