Question

1. Case Study 4: Multiple Sclerosis (MS) is an auto-immune neurological condition of the Central Nervous System (CNS), in which the body’s immune system begins to recognise myelin as a foreign substance and destroys it. The loss of myelin can make it hard for the brain to send and receive signals to and from the rest of the body.

Question:  What impact does the destruction of myelin have on a neuron?

	A.	Decreases the ability to generate an action potential
	B.	Limits the ability to reproduce
	C.	Decreases the ability to release neurotransmitters
	D.	Decreases the speed in which the action potential travels down the neuron
	E.	Slows down the rate in which it depolarises

2.

Case Study 4: Multiple Sclerosis (MS) is an auto-immune neurological condition of the Central Nervous System (CNS), in which the body’s immune system begins to recognise myelin as a foreign substance and destroys it. The loss of myelin can make it hard for the brain to send and receive signals to and from the rest of the body.

Question: What cells will attempt to support the damaged neurons, in someone with MS?

	A.	Neurons
	B.	Schwann Cells
	C.	Myocytes
	D.	Lymphocytes
	E.	Oligodendrocytes

3.

Case Study 4: Multiple Sclerosis (MS) is an auto-immune neurological condition of the Central Nervous System (CNS), in which the body’s immune system begins to recognise myelin as a foreign substance and destroys it. The loss of myelin can make it hard for the brain to send and receive signals to and from the rest of the body.

Question: Some MS patients will experience impaired communication between the CNS & the efferent division of the Somatic Nervous System. Which of the following could be a resulting sign/symptom of this?

	A.	Muscle weakness
	B.	Decreased sensation/feeling
	C.	Decreased heart rate
	D.	Decreased digestive functions
	E.	Disorientation/confusion

4.

Case Study 4: Multiple Sclerosis (MS) is an auto-immune neurological condition of the Central Nervous System (CNS), in which the body’s immune system begins to recognise myelin as a foreign substance and destroys it. The loss of myelin can make it hard for the brain to send and receive signals to and from the rest of the body.

Question: Some MS patients may begin to experience bladder & bowel (digestive) complications. This would be likely due to the impaired connection between the CNS & which other division of the nervous system (NS)?

	A.	Somatic NS
	B.	All of the answers are correct
	C.	Brachial Plexus
	D.	Parasympathetic NS
	E.	Sympathetic NS

5.

Case Study 3: Susan is a 42 year old female, who presents to her doctor complaining of sporadic abdominal pain. She explained that she experiences most pain after meals. An ultrasound later confirms that Susan has gallstones, a condition she has had in the past. Gall stones are hardened deposits that can form in your gallbladder. Gallstones can cause blockages which result in severe pain, along with other symptoms.

Question: The doctor explained to Susan that the ultrasound has detected the gallstones have blocked a duct, which is preventing the breakdown of certain foods. Which duct is the doctor likely referring to?

	A.	Pyloric duct
	B.	Pancreatic duct
	C.	Duodenal duct
	D.	Common bile duct
	E.	Gastric duct

6.

Case Study 3: Susan is a 42 year old female, who presents to her doctor complaining of sporadic abdominal pain. She explained that she experiences most pain after meals. An ultrasound later confirms that Susan has gallstones, a condition she has had in the past. Gall stones are hardened deposits that can form in your gallbladder. Gallstones can cause blockages which result in severe pain, along with other symptoms.

Question: What type of food is most likely to worsen Susan’s pain:

	A.	Food high in protein
	B.	Food high in salt
	C.	Food high in lipids
	D.	Food high in sugar
	E.	Food high in carbohydrates

7.

Case Study 3: Susan is a 42 year old female, who presents to her doctor complaining of sporadic abdominal pain. She explained that she experiences most pain after meals. An ultrasound later confirms that Susan has gallstones, a condition she has had in the past. Gall stones are hardened deposits that can form in your gallbladder. Gallstones can cause blockages which result in severe pain, along with other symptoms.

Question: In the past, gallstones have not caused Susan grief because they have passed through the appropriate duct & through the remainder of the digestive tract. What structures, in order, would the gallstones have passed through before exiting the body?

	A.	Duodenum, ilium, jejunum, ascending colon, descending colon, rectum
	B.	Duodenum, jejunum, ilium, ascending colon, transverse colon, descending colon, rectum
	C.	Jejunum, Ilium, descending colon, transverse colon, ascending colon, rectum
	D.	Stomach, small intestine, large intestine, rectum
	E.	Ascending colon, transverse colon, descending colon, rectum

8.

Case Study 3: Susan is a 42 year old female, who presents to her doctor complaining of sporadic abdominal pain. She explained that she experiences most pain after meals. An ultrasound later confirms that Susan has gallstones, a condition she has had in the past. Gall stones are hardened deposits that can form in your gallbladder. Gallstones can cause blockages which result in severe pain, along with other symptoms.

Question: Which process/es of digestion has the blockage caused by the gallstones impacted:

1. Mechanical digestion
2. Chemical Digestion
3. Absorption
4. Peristalsis

	A.	2 only
	B.	1 & 4
	C.	3 only
	D.	2 & 3
	E.	1 & 3

9.

Case Study 3: Susan is a 42 year old female, who presents to her doctor complaining of sporadic abdominal pain. She explained that she experiences most pain after meals. An ultrasound later confirms that Susan has gallstones, a condition she has had in the past. Gall stones are hardened deposits that can form in your gallbladder. Gallstones can cause blockages which result in severe pain, along with other symptoms.

Question: Which of the following symptoms would you NOT expect someone with gallstones to experience?

	A.	nausea
	B.	pain urinating
	C.	abnormal coloured faeces
	D.	reflux
	E.	diarrhea

10. Epidemiologists quantify the frequency of disease by developing a definition of the disease, instituting a mechanism for counting cures of disease within a population, and determining the size of that population. It is only when the number of cures are related to the size of the population that we know the true frequency of disease.

A True

B False

11. What is the primary difference between public health and medicine?

	A.	Public health focuses on preventing diseases in communities, and medicine focuses on treating diseases at the individual level.
	B.	Medicine focuses on preventing diseases in communities, and public health focuses on treating diseases at the individual level.
	C.	Public health and medicine both have the same focuses on preventing diseases and treating diseases at the individual level.
	D.	Public health focuses on cells, tissues and animals in laboratory settings, and medicine focuses on treating diseases at the individual level.
	E.	Public health focuses on improving diagnosis and treatment of disease, and medicine focuses on prevention of disease promotion of health.

12.

What was the inital goal of the Framingham Study?

	A.	To develop ways identifying lung cancer and smoking among healthy volunteers.
	B.	To develop ways identifying tuberculosis and streptomycin among healthy volunteers.
	C.	To develop ways identifying cholera and drinking water among healthy volunteers.
	D.	To develop ways identifying cardiovascular disease among healthy volunteers.
	E.	None of the above

13.

The original Streptomycin Tuberculosis Trial was conducted in Australia during the 1980s.

A True

B False

14.

James Lind conducted one of the first observational studies in the neighborhoods of 19th-century London and discovered that contaminated drinking water was the cause of cholera.

A True

B False

15.

Population is a group of people with a common characteristic.

A True

B False

16.

Define disease frequency

Disease frequency is ...

A		the ultimate aim of epidemiology and refers to the reduction or elimination of disease occurrence. It is accomplished through epidemiological research and surveillance.
B		a pattern of disease according to the characteristics of person (who is getting the disease?), place (where is it occurring?) and time (how is it changing over time?).
C		a group of people with a common characteristic.
D		a measure of disease frequency quantifies how often a disease arises in a population. Its calculation involves establishing the disease definition, developing a mechanism for counting the diseased cases (the numerator), and determining the size of the underlying population (the denominator).
E		a factor that bring about a change in a person’s health or make a difference in a person’s health.

Answer 1

1)

A	Wrong	The myelin sheath has no role in generation of action potential. It plays a role in propagation of action potential.
B	Wrong	The myelin sheath has no role in multiplication of neurons.
C	Wrong	The myelin sheath has no direct effect on release of neurotransmitters.
D	Right	Myelin is involved in propagation of action potential along the axon. If it is damaged, then the velocity of conduction will decrease.
E	Wrong	As stated earlier , the myelin has no role in generation of action potential.

2)

Neurons	wrong	The neurons don't support the damaged neurons.
Schwann cells	wrong	Multiple sclerosis is a disease of Central nervous system and Schwann cells is a part of Peripheral nervous system.
Myocytes	wrong	There is no link between myocytes and damaged neurons.
Lymphocytes	right	They appear to be supporting the damaged neurons but i fact, they are causing more damage to the neurons.
Oligodendrocytes	Wrong	It is the oligodendrocytes which are getting damaged. Myelin is not formed hence neurons are ultimately getting damaged.

3)

A	Right	As efferent division (ie motor) of Somatic nervous system (ie which controls the muscles) is damaged, muscle weakness will be a symptom.
B	wrong	Sensations are taken by afferent, not efferent.
C	wrong	Heart rate is influenced by autonomic nervous system.
D	Wrong	Digestive system is also influenced by autonomic nervous system, not Somatic nervous system.
E	wrong	Disorientation/confusion occurs if there is brain parenchymal damage. Somatic nervous system has nothing to do with them

4)

Somatic	wrong	Bladder and digestive functions are controlled by autonomic system, not by Somatic system.
Brachial	wrong	Brachial plexus involvement will produce movement loss on the upper limb, not bladder and GIT.
Parasympathetic	Right	Multiple sclerosis more affects the parasympathetic system than the sympathetic system.
Sympathetic	Wrong	It is also involved in multiple sclerosis, but primarily parasympathetic dysfunction is responsible for the bladder and digestive symptoms. {But if multiple options to be chosen, both Parasympathetic and sympathetic can be chosen}