174 Questions
What is the effect of cyclin D on the retinoblastoma tumour suppressor gene?
It phosphorylates and activates Rb
What is a characteristic of neoplasia?
A permanently altered growth pattern
What is the result of sustained angiogenesis in cancer cells?
Development of new blood vessels
Which of the following can accelerate the cell cycle?
Activation of oncogenes
What is the role of a proto-oncogene?
To promote normal cell growth
What is the result of evading apoptosis in cancer cells?
Uncontrolled cell growth
What is the primary mechanism by which ligands cause the activation of oncogenes?
By binding to the oncogene receptor, causing ligand-dependent activation
Which of the following types of chemical signalling involves the secretion of hormones into the bloodstream?
Endocrine signalling
What is the result of gene amplification in oncogenes?
Overexpression of the oncogene
Which of the following oncogenes is commonly associated with breast cancer?
HER2
What is the primary mechanism of action of the EGFR-targeted drug cetuximab?
By binding to the EGFR receptor, it blocks the binding of EGF
What is the role of Ras in the cell cycle?
It propagates signals downstream, inducing cell division and growth
What is the result of the mutation of Ras in cancer cells?
It leads to the activation of downstream signalling pathways, promoting cell division and growth
What is the primary function of tumour suppressor genes?
To regulate cellular proliferation and induce apoptosis in cells with damaged DNA
What is the result of the amplification of the N-myc gene in neuroblastomas?
It results in the overexpression of the oncogene
What is the role of E2 in the cell cycle?
It helps the cell cycle to progress to the S phase
What is the result of a normal cell being affected by chemicals, carcinogens, radiation, and viruses?
DNA repair
What is the term that describes the differences between tumors of the same type in different patients?
Tumor heterogeneity
What is the event that stimulates clonal proliferation of the initiated cell?
Promotion
What is the role of BRCA and Rad51 in breast cancer?
Mutated genes in 50% of breast cancer patients
What is the result of a person's skin and tissue being extremely sensitive to sunlight and some other forms of ultraviolet (UV) light?
Xeroderma Pigmentosum
What is the consequence of a person with XP being unable to repair DNA damage?
Difficulty in repairing DNA damage by UV light
What is the name of the hypothesis that explains how retinoblastoma can occur?
Knudson's Two Hit Hypothesis
What is the function of the p53 tumour suppressor gene?
To activate apoptosis
What is the name of the syndrome characterised by germline mutations in p53?
Li-Fraumeni syndrome
What is the role of the APC/Beta-catenin gene?
To inhibit signal transduction
What protein is involved in DNA damage repair and is rendered ineffective by BRCA mutation?
Rad51
What is the outcome of a cell with an abnormal p53 tumour suppressor gene when DNA is damaged?
The cell becomes cancerous
What is the result of sustained angiogenesis in cancer?
The tumour outgrows its blood supply
What is the mechanism of immune evasion in cancer?
Cancer cells develop mechanisms to evade detection by the immune system
What is the name of the drug approved by NICE in 2017 for the management of head and neck cancer?
Nivolumab
What is the hallmark of cancer that involves the adaptation of more glycolytic pathways of metabolism?
Altered metabolism
What is the primary system affected by rheumatic fever?
Cardiovascular system
What is the common age range for rheumatic fever?
5-15 years
What is the latent period before rheumatic fever sets in?
2-6 weeks
What is the most common valve affected by rheumatic fever?
Mitral valve
What is the term for the inflammation of blood vessels that can occur in rheumatic fever?
Vasculitis
What is the name of the nodules that can form in the heart muscle in rheumatic fever?
Aschoff nodules
What is a common characteristic of patients who are at risk of developing infective endocarditis?
Having structural cardiac defects or acquired valvular heart disease
How can a dentist contribute to the prevention of infective endocarditis?
By removing caries and promoting good oral hygiene practices
What is haematuria a sign of?
Kidney stone or tumor in the urinary tract
What is a possible cause of haematuria?
All of the above
What does the presence of white blood cells in the urine, in addition to red blood cells, indicate?
Urinary tract infection
What is a possible cause of urinary tract infection?
Bacterial infection
What is the primary site where bacteria thrive in intravenous drug users with periodic introduction of foreign material?
Nidus
What percentage of endocarditis patients have negative blood cultures?
5-10%
What is the criteria for diagnosing rheumatic fever?
The presence of 2 major and 1 minor criteria
What is the main characteristic of polyarthritis in rheumatic fever?
It is a migratory joint inflammation that lasts for 4-6 weeks
What is the characteristic of heart disease that includes conditions that narrow or block blood vessels?
Conditions that narrow or block blood vessels
What is the association of carditis with rheumatic fever?
It is present in 40-50% of patients and lasts for 3-6 months
What is the sign of heart disease that involves the development of a new murmur?
Development of a new murmur
What is the result of excessive complement activation in endocarditis patients?
Development of immune complexes
What is the characteristic of erythema marginatum in rheumatic fever?
It is a circular rash with a pale-pink center, surrounded by a raised red outline
What is the percentage of endocarditis patients with positive blood cultures?
75%
What is the association of chorea with rheumatic fever?
It is a movement disorder that occurs in 10-20% of patients
What is the purpose of antibiotic prophylaxis in endocarditis?
To reduce antibiotic resistance
What is the main characteristic of subcutaneous nodules in rheumatic fever?
They are deep-seated lesions that occur over bony prominences
What is the consequence of an organism that cannot be identified in endocarditis patients?
The prognosis is worse
What is the association of endocarditis with rheumatic fever?
It is a common complication of rheumatic fever
What is the result of immune complexes in endocarditis patients?
Development of Osler's nodes and splinter hemorrhage
What is the main reason for the increasing incidence of endocarditis?
Increasing number of elderly people with abnormal/prosthetic valves
What is the name of the medical term that predicts the likely or expected development of a disease?
Prognosis
What is the main characteristic of Sydenham's Chorea?
It is a movement disorder that disappears during sleep
What is the main characteristic of erythema nodosum in rheumatic fever?
It is a swollen fat under the skin causing bumps and patches
What is the definition of dysphagia?
Difficulty in swallowing
What is a symptom of dysphagia?
Something sticking in the throat/chest during swallowing or immediately after
Which type of tumour is commonly associated with dysphagia in the upper 1/3rd of the oesophagus?
Squamous cell carcinoma
What is the cause of dysphagia in a patient with a foreign body obstruction?
A bone stuck in the oesophagus
What is the result of a failure of relaxation of the cardiac sphincter in achalasia?
Obstruction of oesophageal emptying with dysphagia for solids and liquids
What is the characteristic of a web, a type of oesophageal stricture?
A fibrous stricture that forms at the upper end of the oesophagus
What is the effect of chronic inflammation on acid production in the stomach?
It decreases acid production
What is the consequence of reduced intrinsic factor production in the stomach?
Impaired absorption of vitamin B12
What is the most common age range for carcinoma of the oesophagus?
Over 50s
What is a risk factor for carcinoma of the oesophagus?
All of the above
What is a symptom of carcinoma of the oesophagus?
Dysphagia
What is a local spread effect of carcinoma of the oesophagus?
Fistulae to the trachea
What is the majority type of carcinoma present in oesophagus carcinoma?
Squamous cell carcinoma
What is a diagnostic method for carcinoma of the oesophagus?
All of the above
What is the main reason for oesophagitis?
Inflammation of oesophagus due to reflux from the stomach that is very acidic
What is a treatment option for carcinoma of the oesophagus?
Surgery, radiotherapy, or stent
What is the characteristic of vomited blood in haematemesis?
Dark and coffee-ground-like
What is the weak point of the oesophagus called?
Killian's dehiscence
What type of muscle coats the inner and outer layer of the oesophagus?
Circular and longitudinal muscle coats
What is the main characteristic of pharyngeal pouch disease?
Herniation of mucosa through a weakness in the pharyngeal constrictor muscles
What is the term for the passage of pale bulky stools that contain fat?
Steatorrhoea
What is the type of epithelium that lines the mucosal layer of the oesophagus?
Stratified Squamous Non Keratinising Epithelium
What is the result of the relaxation of the gastro-oesophageal sphincter?
Achalasia of the cardia
What is the term for the sensation of a lump in the throat?
Globus hystericus
What is the term for the abnormal contractions of the oesophagus?
Oesophageal spasm
What is the term for the difficulty in swallowing?
Dysphagia
What is the result of achalasia of the cardia?
Functional obstruction to oesophageal emptying with dysphagia for solids and liquids
What is the primary cause of oesophageal webs?
Premalignant conditions
What is the difference between peptic and gastric ulcers in terms of affected areas?
Peptic ulcers affect the oesophagus, stomach, and duodenum, while gastric ulcers only affect the stomach
What is a potential consequence of an oesophageal spasm?
A corkscrew oesophagus formation
What is the common aetiology of peptic and gastric ulcers?
Mucosal inflammation due to acid and pepsin destruction of lining mucosa
What is the treatment for oesophageal webs?
All of the above
What is the difference between acute and chronic duodenal ulcers?
Acute ulcers only affect the muscularis mucosae, while chronic ulcers penetrate the submucosa and muscular wall
What is a consequence of peptic ulcer scarring?
Scarring may lead to a stricture or obstruction
What is the role of H. pylori in peptic ulcer disease?
It colonises the mucus and contributes to the development of the ulcer
What is the treatment for peptic ulcers?
All of the above
What is the primary consequence of liver damage?
Hepatocytes are lost and fibrosis occurs
What is the route of transmission of hepatitis A?
Contaminated food and water through the faeco-oral route
What is a common symptom of liver failure?
Jaundice
What is the result of chronic liver damage?
Liver failure
What is Sjogren's syndrome associated with?
Body fluids like saliva and sweat
What is a consequence of liver failure on the kidneys?
Secondary renal failure
What is the incubation period of hepatitis A?
2-6 weeks
Where is hepatitis E most common?
India
What is the mortality rate of pregnant women with hepatitis E?
20%
How is hepatitis B spread?
Through sexual contact or infected blood
What is the ratio of carriers to being positive with hepatitis B?
1:4
What determines if hepatitis B is an acute infection?
HBsAg levels increase and decline at 12 weeks
What determines if hepatitis B is a chronic infection?
HBsAg levels increase and stay high
How is hepatitis B infectious in saliva?
Through blood content
What is the incubation period of hepatitis B?
2-6 months
What is the percentage of the UK population that has hepatitis B?
0.3%
What is the necessary condition for hepatitis D to infect?
Presence of HBsAg
What is the percentage of people with hepatitis B that have hepatitis D in the UK?
2%
What is the main reason why hepatitis C is described as a severe infection that is often fatal?
The virus mutates faster than the immune response can respond
Which of the following is a common way of transmitting hepatitis C?
Through needle sharing or blood transfusions
What is the percentage of people with hepatitis C in the USA?
2%
Which of the following has a higher risk of transmission via a sharps injury?
Hepatitis B
What is a medically compromised patient?
A patient with a condition that may impact safe and optimal dental care.
How many histories are taken for patients?
5
What may happen to patients with a compromised cardiovascular system?
They may have an acute ischemic event, become breathless when laid flat, and have a bleeding tendency due to anticoagulants.
What is the preferred anaesthetic for a patient with a compromised cardiovascular system?
Citanest as it does not contain adrenaline.
What is infective endocarditis?
Infection of the heart lining.
What are the risk factors for infective endocarditis?
All of the above and more.
Why is it necessary to maintain good oral health in people with infective endocarditis?
To prevent bacteremia and sepsis
What is a common side effect of diuretics in antihypertensive therapy?
Xerostomia
Why is it necessary to have salbutamol at hand when treating patients with respiratory disease?
To treat bronchospasms
What is a dental consideration for patients with diabetes?
All of the above
Why is it necessary to consider the timing of appointments for patients with diabetes?
To prevent hypoglycaemia
What is a potential problem dentally for patients with epilepsy?
All of the above
What is a function of the liver?
All of the above
What is a dental consideration for patients with liver disease?
All of the above
What is a consequence of alcohol dependency?
All of the above
What is the function of corticosteroids?
Both A and B
What is the recommended action if a patient has been taking corticosteroids for over 3 weeks at more than 30mg a day and is having surgery?
Double their normal dose
What is a common dental side effect of corticosteroids?
Oral candidiasis
Why should NSAIDs be avoided with corticosteroid use?
They increase the risk of peptic ulceration
What history should be taken for a patient with a bleeding risk?
Previous episode, Past surgery, Previous treatment, Family history, Relevant Medical History, Drug History
What is the most commonly used long-term anticoagulant?
Warfarin
What is the INR equation?
PT / PT(normal) x IS(N)
What should the INR levels be for a patient taking warfarin to treat DVT or PE?
3.5-4.5
What measures should be taken when performing an extraction on a warfarin patient?
Schedule appointment in the morning, try not to give ID blocks, and do not interrupt warfarin medication
What is the purpose of taking an INR reading for a warfarin patient?
To monitor the patient's warfarin dosage
Why should a dental appointment be booked early in the day and week for a patient with a bleeding risk?
To allow for more time to deal with immediate re-bleeding problems and delayed re-bleeding episodes
What is the term used to describe the collective group of histamine, bradykinin, nitric oxide, eicosanoids, and neuropeptides?
Inflammatory mediators
Which of the following is a microvascular change that occurs in the inflammatory response?
Release of inflammatory mediators
What is the role of the venule in the microcirculation?
Oedema formation and cell accumulation
What triggers the release of histamine from mast cells and basophils?
Allergic/hypersensitivity IgE responses
What is the preferred type of histamine H1 antagonist?
Non-sedating
What is an instance when anti-histamines are used?
Hayfever
What type of fibres do sensory nerves consist of?
C fibres
What is the role of substance P in sensory nerves?
To release neuropeptides
What percentage of sensory nerves mediate itch?
5% of afferent C-fibres
What is the effect of anti-histamines on itch?
They are effective as anti-itch agents
What is the role of prostaglandins in inflammation?
They enhance inflammation
What is the effect of NSAIDs on prostaglandin generation?
They inhibit prostaglandin generation
What is the role of thromboxanes in cardiovascular regulation?
They play a key role in cardiovascular regulation
What is the effect of inhibition of prostaglandin generation?
It reduces pain
What is the role of TNF-alpha in arthritis?
It is the primary mediator of arthritis
What is the effect of Paracetamol on inflammation?
It is not an anti-inflammatory
What is the role of COX-1 in the body?
To maintain homeostasis
What is the primary goal of inhibiting COX-2?
To reduce inflammation
What is the purpose of using proton pump inhibitors with oral NSAIDs?
To inhibit GI reflux
What is the category of DMARDs that includes methotrexate?
Slow acting, second line therapies
What is the effect of anti-inflammatory steroids on lymphocyte T-cell proliferation?
Inhibition
What is the benefit of using biologics in treating arthritis when DMARDs fail?
Counteracts tissue damage and deformities
What is the mechanism of action of IL-6 blockers, such as Tocilizumab?
Blocking IL-6
What is the function of Rituximab in treating arthritis?
Removes antibody-producing WBCs
What is the advantage of using topical NSAIDs?
Has fewer side effects
What is the term for not giving too much steroid for too long?
Steroid sparing
Test your knowledge on cell cycle regulation and neoplasia, including the role of cyclin D and features of abnormal tissue growth. Learn how cyclin D influences the cell cycle and identify key characteristics of neoplasia.
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