RealizeIt Week 2 (Biochem + Oral Path)

Biochemistry
Hormones&EndocrineSystem
Ahormoneactstostimulateitsneighboringcellstodivide.Thishormonewouldbebest
describedasbelongingtowhichcategoryofhormones?
Autocrine
Endocrine
Paracrine
Thesynthesisofallsteroidhormonesinvolveswhichofthefollowingcompounds?
Pregegolone
Cortisone
Testosterone
Aldosterone
Progesterone
TheconversionofcholesterolintosteroidhormonesoccursinAllofthefollowing
organs,withoneEXCEPTION.WhichchoiceistheEXCEPTION?
Testis(inmen)
Pituitarygland
Ovary(inwomen)
Adrenalcortex
Whichofthefollowingstatementsconcerningthechemicalstructureandsynthesisof
hormonesisFALSE?
a)Steroidhormonesareusuallysynthesizedfromcholesterolandarenotstored.
b)Hormonesofthehypothalamusareprincipallyaminehormones.
c)Aminehormonesarederivedfromtyrosine.
d)Steroidhormonesarefoundprincipallyintheadrenalcortex,testes,ovaries,and
placenta.
e)Polypeptideandproteinhormonesarestoredinsecretoryvesiclesuntilneeded.
Whichofthefollowingpairingsofhormoneswithitscategoryofhormoneiscorrect?
Glucacon/steroid
Aldosterone/aminoacidderived
Insulin/pepetide
Cortisol/peptide
ACTH/aminoacidderived
PancreasHormonesEndocrineQuestions

Cholinergicstimulationaugmentsinsulinsecretion.Alphaadrenergicstimulationhasan
inhibitoryeffectoninsulinsecretion.
Thefirststatementsistrueandthesecondstatementisfalse.
Bothstatementsarefalse.
Thefirststatementisfalseandthesecondstatementistrue
Bothstatementsaretrue.
Whichofthefollowingpairingsofisletsecretorycellsandsecretoryproductiscorrect?
cell/pancreaticpolypeptide(not)
Fcell/glucagon
cell/proinsulin
cell/amylin
Thesynthesisandsecretionofislethormonesiscontrolledbyallofthefollowing
communicationmechanisms,withoneEXCEPTION.WhichchoiceistheEXCEPTION?
Autonomic nervous system
Islet cell communication
Hormonal
Peripheral nervous system
Insulin
Thebindingofinsulintotheinsulinreceptorresultsisactivationofwhichenzyme
activity?
Gproteins
campphosphodiesterase
proteinkinaseA
tyrosinekinase
phospholipaseC
Themechanismofinsulinreceptorsignaltransductioninvolves:
FormationofcAMP
Aseventransmembranespanningreceptor
TheJAKSTATtyrosinekinasecascade
Autophosphorylationontyrosineresidues
Translocationofthereceptortothenucleus
Choosethecorrectpairoffactsaboutinsulin:
a)Thegeneisonchromosome11,theactivehormoneconsistsofA,BandCchains
b)Itismadeinalphacellsofthepancreas;itcanactivatephosphatasesintargetcells
c)Theprecursorispreproinsulin,secretionisstimulatedbyanincreaseinATP
d)InsulinstimulatesglucoseuptakebyGLUT2,itactivatesglycogensynthase
Whichofthesepathwaysisstimulatedbyinsulin?

Ketonebodyformation
Gluconeogenesis
Glycogensynthesis
Pentosephosphatepathway
Betaoxidation
Bindingofinsulintoinsulinreceptor
Insulinsecretioniscontrolledbyglucosemetabolisminthepancreaticbetacell.An
increaseinplasmaglucoseresultsinuptakeofglucoseintothebetacellviathe____
transporter,leadingtoincreasedmetabolismofglucoseandanincreaseinthe
concentrationof_____.Thismoleculewillinhibittheactivityof_____channelwhich
causesdepolarizationandsecretionofinsulinfromstoragegranules.
GLUT1,pyruvate,potassium
GLUT4,ATP,sodium
GLUT2,ATP,potassium
GLUT2,ketonebodies,sodium

WhichofthefollowingstatementsisNOTtrueregardinginsulin
signaling?
Thecytoplasmicdomainhastyrosinekinaseactivity
TheinsulinreceptorisinthesamefamilyastheEGFreceptor
cAMPisthemainsecondmessengerproducedbythereceptor
Theinsulinreceptorisadimer
Diabetes
Ketoacidosisistheformationofhighamountsofketonebodies.Whichofthese
statementsaboutketonebodiesisFALSE?
a)Formationwillbeenhancedbyglucagon
b)Ketonebodyproductionoccursinthemitochondria
c)Thecarbonchainsofketonebodiesoftenoriginateinstoredfattyacids
d)Theprocessofsynthesis&oxidationofketonebodiesaretheexactreverseofeach
other
e)ThecommonketonebodiesareacetylCoA&acetaldehyde
Apatientpresentstothepediatricianasthemotherinconcernedaboutweightloss,thirst
andfrequenturination.Bloodtestsshowthatglucoseandketonebodiesareelevated.
Whichformofdiabetesisthemostlikelyinthispatient?
Type2
Type1
Gestational

Inthispatientuptakeofglucoseintowhichtissuewouldbeimpaired?
Red cells
Brain
Adipose
Liver
- Which laboratory test is the best one to assess long term glycemic
control & risk of complications?
Fasting blood glucose
Urinary glucose
C-reactive protein
Lactate dehydrogenase
Glycated hemoglobin
Glucagon & Glycogen Metabolism
Whichoftheseenzymesisactivatedbytheactionofglucagon?
Hormonesensitivelipase
Glucokinase
Isocitratedehydrogenase
AcetylCoAcarboxylase
Pyruvatekinase
Whichofthefollowingpathwaysisstimulatedbyglucagon?
VLDLproduction
Glycolysis
Fattyacidsynthesis
Glycogenolysis
Ureacycle
Glucagonwilldecreasewhichofthefollowing?
Glycogenesis
Glycogenolysis
Bloodglucose
Gluconeogenesis
Glucagonworksviawhichsecondmessenger?
Tyrosinephosphorylation
IP3
Ca2+
cAMP
GlucoseMetabolism
Glucosemetabolismisregulateddirectlybytheconcentrationofbloodandcytosolic
glucoseandindirectlybychangescausedbyreversiblephosphorylation.
Anincreaseinglucosecandirectlycauseanincreaseintheactivityof____and____
becausebothhavea____KMforglucose.

GLUT2,hexokinase,low
GLUT1,hexokinase,high
GLUT1,glucokinase,high
GLUT2,glucokinase,high
GLUT2,glucokinase,low
GLUT1,hexokinase,low

FungalDiseases
Cryptococcosisinfectinisspreadvia
Salivarydroplets
Bloodtransfusion
Throughinhalation
Sexualcontact
Cryptococcosisisnotadimorphicorganism
False
True

HistologicfeaturesofinfectionwithZygomycosisinclude90degreebranchinghyphae
True
False
SymptomscommonlyseenwithinfectionbyZygomycosisinclude:(Chooseallthat
apply)
Xerostomia
Nasalobstruction
Visualchanges
Toothabnormalities
Hearingloss
Facialparalysis
Treatmentfordissemintedchronicinfectionwithhistoplasmosisis:
AmphotericinB
Fluconazole
Selflimitingsndwillgoawayovertimemycelextroche
Candidaisthemostcommonsystemicfungalinfection
False
Themostcommonformofaspergillosisisallergicfungalsinusitis
True
Ahistologicfeatureofaninfectionofaspergillosisis:
Frutingbodies
Spores
Sproutingbranches
Yeastbuds
AngularCheilitisisalsoknownasperleche
True
Commoncausesofpseudomembranouscandidaareassociationwithantibioticusageand
immunosuppression(HIV)
True
WhenCoccidioidomycosisisdisseminatedthroughthewholebodyitiscalled
SouthAmericanfever
SanJoaquinvalleyfever
Dunguevalleyfever
Saprophyticfever
Coccidioidomycosisinfectionisusuallyasymptomaticorflulike

True
Toxoplasmosisisanobligateintracellularprotozoalorganism
True
TheapproximatepercentofadultsinfectedwithtoxoplasmosisintheUSis:
2%
85%
1623%
50%
Coccidioidomycosis
DisseminatedCoccidioidomycosisisassociatedwith
HIV
Drugaddiction
Emphsema
Bulemia
Coccidioidomycosisinfectionisusuallyasymptomaticorflulike
True
WhenCoccidioidomycosisisdisseminatedthroughthewholebodyitiscalled
SouthAmericanfever
SanJoaquinvalleyfever
Dunguevalleyfever
Saprophyticfever
Cryptococcus
Cryptococcosisinfectinisspreadvia
Salivarydroplets
Bloodtransfusion
Throughinhalation
Sexualcontact
Cryptococcosisisnotadimorphicorganism
True
Histoplasmosis
Infectionwithhistoplasmosisisthrough
Sexualcontact
Inhalationofspores

Bloodtransfusionrespiratorydroplets
Treatmentfordissemintedchronicinfectionwithhistoplasmosisis:
Mycelextroche
AmphotericinB
Fluconazole
Selflimitingandwillgoawayovertime
Candidaisthemostcommonsystemicfungalinfection
False
Clinicallyyouwouldfindulcerationoforalmucosawithaninfectionfrom
histoplasmosis
True
Blastomycosis
Blastomycosisisadimorphicorganismthatistransmittedthroughinhalationofspores
True
PatientswithParacoccidioidomycosiswouldhaveobtainedtheinfectionfrom:
SanJoaquinvalleysoil
Batexcrement
Decayingmatter
Contactwithanarmadillo
ThetreamentforacuteblastomycosisisamphotericinB
False(bcnotreatmentrequired)
TheacuteformofblastomycosisinfectionresemblessymptomsofTB
False(acutelikepneumonia,chroniclikeTB)

Aspergillosis
Ahistologicfeatureofaninfectionofaspergillosisis:
Frutingbodies
Spores
Sproutingbranches
Yeastbuds
Themostcommonformofaspergillosisisallergicfungalsinusitis
True
FungalInfectionsCase
Q1:Basedontheclinicalinformation,whatisyourdiagnosis?(spellingcounts)
A:CandidaorCandidiasis
Q2:Howcouldyouconfirmyourdiagnosis?(spellingcounts)
A:Cytology
Q3:Whatisthetreatmentforthiscondition?
A:antifungal,antifungalornystatin
AbnormalitiesofTeeth

DDtype1affectsthecoronalportionofthetooth.
False
Turnershypoplasiaisaformof
Precancerouschange
Agenesis
Amelogenesisimperfecta
Enameldefectinpermanentteethwhichisfocal

Thesyphilitichypoplasiaiscausedbystrepmutans.
False
Thereare4subtypesofAI.Whichofthefollowingisasubtype:
Hypomaturation
Spotted
Agenesis

Hyperplastic
HypoplasticAIresultsfrominadequatedepostionofenamel
True
Concresenceistheunionoftwoadjacenttoothbuds
False
Hypercemetosisisthedepositionoffexcesscementum
True
Anothertermfordensinvaginatusisdensindente
True
The3majorstagesofenamelformationare(chooseallthatapply)
Calcification
Matrixproduction
Mineralization
Eruption
Maturation
Thecessationoferuptionafteremergenceduetoanatomicfusion
ofcementumordentinwiththealveolarboneis
Ankylosis
Gemination
Fusion
Impaction
Patientswithadefectatthegingivalfacialareathathasacleanv
shapedpatternmayhaveabfraction
True
Abrasionisthelossoftoothstructure
Flexionoftheteeth

Anonbacterialchemicalprocess
Duetotoothtoobjectwear
Duetotoothtotoothcontact
DIiscausedfromamutationinDSPPgene(dentin
sialophosphoprotein)
True
DIisahereditarydevelopmentaldefectofdentinwithoutother
systemicdisorder
True
Microdontiaisassociatedwith
Macrodontia
Hyperdontia
Regionalodontodysplasia(not)
Hypodontia
Macrodontiaisrelatedtofusion.
False
Amelogenesis
The3majorstagesofenamelformationare(chooseallthatapply)
Calcification
Matrixproduction
Mineralization
Eruption
Maturation
DevelopmentalAlterationsintheShapeofTeeth
Geminationisthepartialsplittingofatoothbud

True
Themostcommonlocationforenamelpearlis:
Upperincisors
Rootsofmaxmolarsmostcommon
Mandibularcanine

Anothertermfordensinvaginatusisdensindente
True
Thedevelopmentalalterationwherethetoothcountrevealsamissing
toothwhentheanomaloustoothiscountedasonesuggests:
Fusion
Ankylosis
Gemination
Conresence
Teeththattendtoberectangular&exhibitpulpchamberswith
dramaticallyincreasedapicoocclusalheight&bifurcationcloseto
apexexhibit
Taurodontism
Fusion
Concresence
Gemination
Concresenceistheunionoftwoadjacenttoothbuds
False
Anexampleofanaccessorycuspis:
Fusion
Concresence
Taloncusp
Cuspofparello

Hypercemetosisisthedepositionoffexcesscementum
True
DentinDysplasia

DDtype1affectsthecoronalportionofthetooth.
False
RegionalOdontodysplasia
RegionalodontodysplasiaiscausedbyadefectintheDSPPgene
False
DevelopmentalAlterationsinSizeofTeeth
Macrodontiaisrelatedtofusion.
False
Microdontiaisassociatedwith
Macrodontia
Hyperdontia
Regionalodontodysplasia(not)
Hypodontia

DevelopmentalAlterationsinNumberofTeeth
Thecausesofhypodontiainclude:
Damagebeforetoothformationsuchastrauma&infection
Ageneticmutation
Exposuretothesun
Mesiodensisaformof
Macrodontia
Turnerstooth
Hypodontia
Hyperdontia

Therearethreemajorcategoriestodescribethealterationsfoundin
thenumberofteeth
True
Mostcommonlocationforhyperdontiaisthemaxillarypermanent
incisors
True
Hypodontiais(chooseallthatapply)
Morecommoninfemales
Causedbydamagebeforetoothformation
Enamelhyperplasia
Isassociatedwithsyndromes
PostdevelopmentalLossofToothstructure
Ifapatienthaslossoftoothstructureonthemaxillaryfacial
surfaces,theetiologymaybe:
Gastric
Asthma
Dietary
Reflux

Abrasionisthelossoftoothstructure
Flexionoftheteeth
Anonbacterialchemicalprocess
Duetotoothtoobjectwear
Duetotoothtotoothcontact
Lossoftoothstructureisanormalphysiologicprocessthatoccurs
withaging
True

Patientswithadefectatthegingivalfacialareathathasacleanv
shapedpatternmayhaveabfraction
True
Attritionisthelossoftoothstructure
Flexionoftheteeth
Duetotoothtotoothcontact
Duetotoothtoobjectwear
Anonbacterialchemicalprocess
Internalresorption
Needstobeextractedtoresolve
HasaradiographicappearanceofaMotheatenirregulardefect
Mayresultinperforationoftherootfrominternaltoexternal
Maycreateanenamelhypoplasia

ToothabnormalityCase
Whatisthenameforthismalformation?
Regionalodontodysplasia
Whatotherfeaturewouldyouseeintheteeth?
Multipleteethquadrantirregularcrownscariesperiapicallesions
Isthereageneticcomponenttothiscondition?
no
Whatisthetreatmentforthiscondition?
Retentionalteredteethendodonticsbondedrestoration
BacterialInfections

Redstrawberrytongueoccurs10daysafterinfectionwithstrepin
patientswithscarletfever.
False
PastiasLinesareaclinicalsigninwhich
Patientshaveredlinesinthemouth
Thesoftpalateexhibitssnailtracklesions
Pinkorredlinesformedofconfluentpetechiaearefoundinskin
creases
Thereisaheartmurmur
Oralmanifestationsofscarlettfeverincludeawhitestrawberry
tonguewithin2daysoftheinfection.
True
OralmanifestationsofTBinclude:(chooseallthatapply)
Cervicallymphadenopathy
Calcifiedlymphnodes
Exanthem
Painlessulcers
TreatmentforTBis:
Multiagenttherapy
Nystatin
Penicillin
Saltwaterrinses
LongtermuntreatedsecondaryTBcancause:
Scarletfever
Valleyfever
Rheumaticfever
Wastingsyndrome
Inordertodiagnosecatscratchyouwould

Useserologytoconfirm
DNA
Gobytheclinicalsigns
Cytology
Histologyofcatscratchwouldexhibitbartonellahensleainthe
speciminwhenstained.
True
Catscratchdiseaseiscausedbybartonellahensleae.
True
Secondarysyphilis
Occursuponinitialexposure
Occurs510yeaarsafterexposure
Occurs10daysafterexposure
Occursayearafterexposure
Congenitalsyphilisdisplayswhichoralfindings:(chooseallthat
apply)
Strawberrygingivitis
Mulberrymolars
Shovelshapedincisors
Koplickspots
Gonorrhea
Whengonorrheaisfoundinthemouthistypicallyappearsinthe
orophrynx.
True
TheUSremainsthehighestrateofgonorrheathananyindustrialized
country.
True

Treatmentforgonorrheais(chooseallthatapply)
Penicillin
Antibiotics
Nystatin
Fluroquinolones
Syphilis
Congenitalsyphilisdisplayswhichoralfindings:(chooseallthat
apply)
Strawberrygingivitis
Mulberrymolars
Shovelshapedincisors
Koplickspots
Oralfindingsofteritarysyphilisare:
Increasedcandida
Kaposis
petechiae
oralpalatalperforation
Patientswillhavemultiplepapillarylesionscalledcondylomalata
with
Primarysyphilis
Secondarysyphilis
Militarysyphilis
Tertiarysyphilis
Intertiarysyphilisbacteriacangolatentperiod130yearsandthen
showareinfection.
True
The3stagesofsyphillisinclude(chooseallthatapply)

Secondary
Military
Tertiary
Primary
Patientswithprimarysyphiliswillexhibitcankersores.
False
Treatmentforsyphilisispenicillin.
True

SyphillisiscausedbyaninfectionwithTreponemapallidum.
True
Secondarysyphilis
Occursuponinitialexposure
Occursayearafterexposure
Occurs510yearsafterexposure
Occurs10daysafterexposure
StreptococcalTonsilitis
Thetreatmentforstrepthroatis
Antibiotics
Antifungals
Notreatment
Hotwaterrinses
Inordertodiagnoseapatientforstrepthroatyoushouldculturecells
toassurethatthepatienthasstrep.
True
Patentswithtonsilitswilhavesymptomssuchas:(chooseallthat
apply)
Fever

Redtonsils
Candida
Sorethroat
ThemostcommoncauseoftonsillitisistheGroupB,betahemolytic
streptococci.
False(GroupA)
ScarletFever
Oralmanifestationsofscarlettfeverincludeawhitestrawberry
tonguewithin2daysoftheinfection.
True
ScarletfeverarisesfromaGroupAbetahemolyticstrepinfection
that:
oncesystemicerythrogenictoxinfromtheStrepbacteriaattacks
bloodvessels
producesastrawberrygingivitis
producesahighfever
causesatherosclerosis
PastiasLinesareaclinicalsigninwhich
Patientshaveredlinesinthemouth
Thesoftpalateexhibitssnailtracklesions
Pinkorredlinesformedofconfluentpetechiaearefoundinskin
creases
Thereisaheartmurmur
Treatmentforscarletfeveris
penicillin
Nystatin
Noneitisseldlimiting
Tonsillectomy

Redstrawberrytongueocurrs10daysafterinfectionwithstrepin
patietnswithscarletfever.
False
Oralmanifestationsofscarlettfeverincludeawhitestrawberry
tonguewithin2daysoftheinfection.
True
Impetigo
Impetigoiscausedby
Streppyogenes&Staphaureus
Staphaureus
StrepGroupA&Staphaureus
StrepGroupB&Staphaureus
Impetigoisnotinfectious&ismostcommonlyseeninthesummer
False
Thebullousformofimpetigoisseenmostlyinthegeriatric
population.
False(infants)
ViralInfections

HHV4isalsocalledthekissingdisease.
True
Infectiousmononucleosisiscausedby:
Roseola
EpsteinBarrVirus
VaricellaZoster
CMV

Anoralsignofmeaslesis
Vesicles
Candida
Koplickspots
Crustinglesions
RubeolaiscausedbytheParamyxovirusinfection
True
SurvivalrateofpatientsthathavebeeddiagnsoedwithAIDS
increasedto85%since1992.
True
HIVcanremainsilent,causecelldeath,orproducesyncytial
fusionofcells
True
Thereareover100enterovirusesidentifiedtodate.
True
Handfootandmouthdiseaseiscausedby
CoxsackieA10
CMV
CoxsackieA16
EBV
AbiopsyfromapatientwithCMVwoulddemonstrate:
Hyperkeratosis
Owleyenuclei
Orphanannieeyes
ReedSternbergcells

CMVisaherpesvirusandisacommoninfectionfoundinabout
80%ofthepopulation
True
ViralPatientCase
Describethelesion
Multiplevesiclesupperleftlip
Whatistheetiology?
hhv1