Summer exam 2012 - Aalborg Universitet · the question. Dictionaries are available. Quicktionary translator pen is permitted No books, lecture notes or further resources are permitted

Summer exam 2012 Course Title: Reproduction and child health Education: Bachelor Medicine/Medicine with industrial specialisation Semester: 4th semester Exam date: 12th June 2012 Time: 9.00 til 12.00 Evalution form: Passed / not passed Important information:

Remember to write your study number – not name and cpr. nr. – on each page

to be included in the evaluation

Remember to hand in your exam paper, also if you leave the exam before time.

This paper may NOT be removed from the examination room after completion of

the exam paper. Drafting paper is not to be handed in.

The exam paper has to be photocopied so please write within the borders

allocated for each question. The space allocated for each question provides you

with an idea about the maximum length of the answer. Each question states the

maximum number of points. The box “points achieved” is only used for marking

the question.

Dictionaries are available. Quicktionary translator pen is permitted

No books, lecture notes or further resources are permitted.

Answers to questions can be written in Danish or English.

The exam is a mixture of multiple choice questions (MCQ), multiple option

questions, short and long essay type questions. Please use the separate sheet

provided on the following page for the answers to multiple choice questions

1-20.

Total number of questions Module 4.2 : 38

No form of communication is allowed

Module 4.2 Questions

Exam 12th June 2012 4th Semester

Total points acheived on this page

ANSWER SCHEME FOR MULTIPLE CHOICE QUESTIONS EXAM 4.2 CHILD GROWTH.

Opgave Svar

1

2

3.1

3.2

3.3

4

5.1

5.2

6

7.1

7.2

7.3

8

9

10

11

12




13

14

15.1

15.2

16

17

18

19.1

19.2

20

MCQ TOTAL = 28 points




Module 4.2 Questions. Questions 1-20 inclusive are Multiple Choice Questions (MCQ) and should be

answered on the separate sheet of paper after the first page.

1 Which of the following is true regarding factors that modulate growth

hormone secretion?

A Increased blood glucose stimulates growth hormone secretion

B Exercise inhibits growth hormone secretion

C Obesity stimulates growth hormone secretion

D Deep sleep stages II and IV inhibit growth hormone secretion

E Increased blood free fatty acids inhibit growth hormone secretion

Max point 1 Opnåede point

2 Identify the initial site for the formation of the fetal blood cells?

A chorion

B amniotic cavity

C embryoblast

D endoderm

E yolk sac

Max point 1 Achieved point

3 Topic: congenital defects and their basis

Options:

A Chromosomal abnormalities

B Deformation

C Disruption

D Functional defect

E Malformation

F Multiple malformation syndromes

G Sequence

H Single gene defect

I Single primary defect

J Structural defect

K Teratogenesis

Lead in: From the above list, choose the term that most fully describes the

nature of the following abnormalities

Stem:

3.1 A process which alters normal structures after their formation, e.g. amniotic bands




3.2 An environmental agent that causes abnormalities, e.g. rubella

3.3 Multiple abnormalities following a single primary defect, e.g. Pierre Robin Syndrome


4 Which one of the following statements does NOT apply to growth

hormone (GH) secretion and its actions on target tissues?

A GH induces secretion of Insulin-like Growth Factor (IGF) in the liver

B GH increases glucose uptake in adipose tissue

C GH increases amino acid uptake in muscle tissue

D GH exerts negative feedback on GH secretion in the anterior pituitary

E GH triggers cell division


5 Topic: Use of drugs in labour

A Beta adrenoreceptor agonist

B Beta adrenoreceptor antagonist

C Corticosteroid

D Non steroidal anti-inflammatory drugs

E Oestrogen

F Oxytocin

G Progesteron

H Prostaglandins

Lead in: For each of the circumstances below choose the most appropriate drug

from the list above.

Stem:

5.1 Used in a gel given intra-vaginally to induce labour

5.2 Used to augment a slow non-obstructed labour


6 Which one of the following statements regarding fetal/neonatal physiology and

anatomy is not correct?

A A normal umbilical cord contains two arteries and one vein

B Pulmonary vascular resistance increases at birth

C Right to left shunting occurs across the foramen ovale in utero

D Systemic vascular resistance increases at birth




E The ductus arteriosus begins to close within 24 hours of birth


7 Drugs in pregnancy.

A Cocaine

B Warfarin

C Alcohol

D Thalidomide

E Misoprostol

F Lithium

G Methadone

H Penicillamine

I Valproic acid

J Diazepam

Lead in: Choose the correct statement regarding teratogens:

7.1 … acts as a teratogen during all trimesters but can cause different

effects in each trimester

7.2 … acts as a teratogen during the first trimester and is likely to cause

Ebstein’s anomaly

7.3 … acts as a teratogen on the first trimester and is known to cause e.g.

neural tube defects


8 Which one of the following is correct about pregnancy?

A Basal metabolic rate rises by more than 10%

B Breasts enlarge due mainly to the action of prolactin

C Haematocrit rises

D The uterus is quiescent until the onset of labour

E Uterine muscle enlarges due mainly to cell proliferation


9 Ms JO has just delivered a baby at 29 weeks. The family asks about long term

problems resulting from this. Which one of the following is not more common

than in full term labors?

A Cerebral palsy

B. Chronic lung disease

C. Diabetes mellitus

D Learning difficulties

E Visual impairment





11 Question: Hvordan vil ændret stofskifte (hypothyreoidisme eller

hyperthyreodisme) vise sig hos børn.

A Dyb stemme.

B Hårtab af øjenbrynene.

C Hæmning af længdevæksten

D Kolde hænder og fødder

E Vandladningsproblemer


12 Find det forkerte svar:

Hvilken af følgende faktorer disponerer IKKE for post partum blødning?

A Instrumentiel forløsning

B Sectio

C Partus prolongata

D Partus spurius

E Multiparitet

F Preterm fødsel

H Foetus magnus


13 Hvad er den væsentligste årsag til perinatal mortalitet og svær

perinatal morbiditet i Danmark?

A Gestationel diabetes

B Preterm fødsel

C Graviditas prolongata

D Præeclampsi

E Maternel adipositas

F Intrauterin væksthæmning (IUGR)

10 Choose the correct answer:

Which of the following typically causes the least amount of

congenital malformations?

A Mechanical deformations

B Drugs, chemicals, radiation, hyperthermia

C Genetic diseases

D Maternal infection

E Maternal condition





G Hyperemesis gravidarum


14 Identify which TWO parts of the fetal-placental boundary that are

of maternal origin

A Chorionic plate

B Decidual plate

C Syncytiotrophoblast

D Blood in the chorionic villi

E Extraembryonic mesoderm

F Blood in the intervillous space


15 Topic: Hormones associated with sexual cycle and pregnancy.

Molecules:

A Oxytocin

B GnRH

C Progesterone

D hCG

E Prolactin

F Estriol

G FSH

H Estradiol

I LH

J Testosterone

Opgave: Vælg fra listen af molekyler den, der passer bedst til hvert af de

nedenstående udsagn.

15.1 Is the most important estrogen produced by placenta

15.2 Is involved in the lactation reflex and uterine contractions


16 The role of prolactin is to stimulate lactation; nevertheless, during

pregnancy no milk is produced. This is due to which one of the

following?

A Low levels of prolactin

B Low levels of prolactin-releasing hormone

C High levels of estrogen and progesterone




D High levels of oxytocin

E Absence of the neurosensory stimulation of the nipple


17 Which of the following is TRUE regarding child abuse?

A It is a physical mistreatment of children

B It can take many forms, such as neglect, physical abuse, child sexual abuse, and

psychological abuse

C Child neglect and child abuse are far more common in single-parent families

than in families where both parents are present

D Child abuse is a complex problem which has multiple causes

E All of the above


18 After delivery of a baby there is a marked fall in the level of oestrogen in the

mother’s blood. Which one of the following is unlikely to be a consequence of

this?

A Depression

B Hot flushes

C Increased blood coagulability

D Tiredness

E Vaginal dryness


19 Topic: The development of the heart.

Description:

A Fusion of the septum primum and septum secundum

B Formation of the interventricular septum

C Formation of the conotruncal septum

D Fusion of the endocardial cushions

E Folding of the endocardial heart tube

F Formation of the semilunar valves

G Closure of the ductus arteriosus

H Formation of the atrioventricular valves

Opgave: Vælg fra listen, der passer bedst til hvert af de nedenstående udsagn.

19.1 Persistent foramen ovale is a defect of ….




19.2 Formation of the isolated pulmonary and systemic circulations in early

postnatal life requires in addition to closure of foramen ovale, which option in

the above list

20 Which one of the following statements does NOT apply to

acromegaly?

A Excess growth hormone during childhood causes overgrowth of the long

bones and very tall stature

B Enlarged lips, nose, and tongue

C Excessive sweating and skin odor

D Abnormalities of menstrual cycle, sometimes breast discharge

E Swelling of the hands and feet is often an early feature





SHORT ANSWER AND ESSAY QUESTIONS TO BE COMPLETED IN

SPACES PROVIDED

Jimmi Cooper, a boy aged 16 months, is brought to see you by his parents. He has

been slow in walking and has recently been seen by the local paediatrician and a

diagnosis of Duchenne muscular dystrophy has been made.

21.1 At what age does this disease usually first manifest?


21.2 What is the appearance of the muscles on physical examination and why does this happen?


21.3 As part of the screening process, a PCR will be run on biomarker gene.

The materials needed for running the PCR are listed in the table below.

Calculate the volumes needed (column 3) for a 20µl reaction based on the

final concentrations stated in column 2 of the table.

Calculate what volumes you would need for each of the reagents in a 20

µl reaction.

Reagents and template Final concentration in a

reaction volume of 20 µl

Volume (µl)

10 x Taq buffer 1 x

dNTP Mix, 25 mM 0.25 mM

Forward primer, 200 µM 1 µM

Reverse primer, 100 µM 1 µM

Taq DNA polymerase, 5u/µl 0.5 u

Template 1 µl 1µl

MgCl2, 10 mM 2 mM

Water Fill to 20 µl

Mark 5

22 What are the main hypothalamic hormones regarding growth regulation

(give six examples)?

21 Patient History




What are the main anterior pituitary hormones regarding growth

regulation (give four examples)?

What are the main posterior pituitary hormones regarding growth regulation (name both hormones)?

Hypothalamic:

Anterior pituitary gland:

Posterior pituitary gland

-


23 What is the purpose of chorionic villus sampling during pregnancy?

What are some risk factors associated with this test?

Max points 2 Achieved point

24 Perinatal mortalitet og maternel mortalitet er to centrale

epidemiologisk mål i forhold til fødsler:

Hvordan defineres henholdsvis perinatal mortalitet og maternel

mortalitet? (2 points)




Perinatal mortalitet –

Maternel mortalitet –


25

Cite and explain succinctly the 2 most common types of hearing

impairment


26 The placenta can have abnormalities in the way it adheres to the uterine wall.

Name 2 examples of placenta abnormalities?





27 Give three important reasons for examination of the placenta immediately

after its birth.


28 Describe the remnants of fetal circulation that are present in adult life.


29 Explain the changes to blood circulation immediately after birth?





30 Topic: The development of the heart

Formation of the isolated pulmonary and systemic circulations in early

postnatal life requires closure of 2 important structures. What are these

structures?


31 I henhold til de danske anbefalinger for svangreomsorg, hvornår bør

lavrisikogravide da tilbydes konsultation hos egen læge?


32 Hvad er en double test og hvornår kan en sådan test udføres?





33 Beskriv lægens opgaver ved den første, rutinemæssige svangreundersøgelse





34 What is an Apgar score and what parameters are measured? Answer by

making a table to explain the points system





35 Draw and describe a classical growth curve for children in the first 5

years. For maximum points label the axis correctly. (5) If a child if failing to thrive, where would it be placed on the growth

curve (place a mark/line on your drawing) and substantiate your

answer giving an example. (3)





36 Hvad er forskellen på symmetrisk og asymmetrisk intrauterin

væksthæmning (IUGR)?

Symmetrisk væksthæmning:

Asymmetrisk væksthæmning:

Max points : 2 Achieved point

37.0 Case Question:

Christina Petersen is 17 years old and a patient in your practice. She is pregnant for the first time.

37.1 On enquiry you ascertain that she smokes 15 cigarettes at the weekend.

What is the consequence of smoking on the fetus? Give 2 examples

1

37.2 You also determine that she drinks about ten units of alcohol at the

weekend. Give two consequences for the fetus of alcohol consumption.

2

37.3 What would you prescribe to the patient at this point in the pregnancy and

why?




2

38 Draw a diagram illustrating the placental anatomy at 4 months gestation

labeling the fundamental structures and layers.




Max points 8 Achieved point

Documents

Summer exam 2012 - Aalborg Universitet · the question. Dictionaries are available. Quicktionary translator pen is permitted No books, lecture notes or further resources are permitted