18 March 2008 Paper II Physiology and Biochemistry
Question 1
Discuss the physiology of
a) Toll-like receptors. (9)
b) Tumour necrosis factor. (8)
c) Interferon. (8) [25]
Question 2
Write an essay on the short- and long-term effects of ultraviolet light on the skin. [25]
Question 3
A fire-fighter sustained burns to his face, neck, arms, and chest while trying to put out a fire in a Johannesburg suburb and was admitted to a nearby hospital. He complained of intense pain on his face and neck, both of which exhibited extensive blistering and redness. The chest and arms exhibited a pale waxy appearance, was leathery, and insensate (without sensation, including pain). The attending physician said that third degree burns were present on the chest and arms and excision of the traumatised tissue and subsequent skin grafting would be required in those regions. The face and neck had second-degree burns. Because of the lack of resources, skin grafting was not performed and extensive scarring was present after healing.
a) Describe the sequence of events that occurred during the wound-healing process. (25)
b) List the major functions of the skin and discuss how the accident might affect each after the skin has healed. (25) [50]
1 Write notes on
a) Pathogenesis of atherosclerosis.
b) Leucocytoclastic vasculitis.
c) Dystrophic calcification. [25]
2 Discuss different mechanisms by which viruses cause disease. [25]
3 Define and discuss granulomatous inflammation. Discuss the differential diagnosis of a granulomatous inflammatory reaction in the dermis. [25]
4 a) Define metaplasia and dysplasia. Give examples of dysplasia in the skin and comment on the grading of dysplasia.
b) Write short notes on the evolution of
i) Kaposi’s sarcoma;
ii) Squamous cell carcinoma and other malignancies in transplant recipients.
27 August 2008 Physiology & Biochemistry Paper II
1 Discuss the physiology of wound healing. [25]
2 Write short notes on:
a) the cell cycle, giving a schematic representation (15)
b) epidermal growth factor. (10) [25]
3 a) Describe the formation of vitamin D in the skin and its subsequent hydroxylation in the liver and kidneys. (10)
b) Discuss the actions of vitamin D as well as the regulation of vitamin D synthesis. (15) [25]
4 Write short notes on:
a) body heat production (8)
b) body heat loss. (7) [25]
28 August 2008 Principles of Pathology Paper III
1 a) Describe with examples the roles of proto-oncogenes and tumour suppressor genes in the aetiology of cancer.
b) What is inflammation? What are the basic characteristics of acute inflammation? [25]
2 a) Discuss the aetiology of autoimmune diseases.
b) List the features of apoptosis and necrosis. [25]
3 Write short notes on
a) Intracellular accumulation of pigments.
b) Neurofibromatosis.
c) Skin diseases associated with Herpes Viruses. [25]
4 Write short notes on
a) Beneficial and harmful effects of solar radiation.
b) Amyloidosis.
c) Teratomas. [25]
28 August 2008 Principles of Pathology Paper I
1 a) Define a granuloma.
b) Discuss immunological aspects of granuloma formation.
c) Draw the various types of giant cells and their clues to clinical diagnosis.
d) Define caseous necrosis.
e) Outline the various histopathological differences between the various granulomatous skin conditions. [25]
2 a) Please identify the structure illustrated below (figure1) and describe the cycle of the structure shown. (13)
Figure 1
b) Please identify the gland illustrated below (figure 2). Write short notes on the anatomy, histochemistry and relevance to cutaneous disease of the gland shown. (12)
Figure 2
3 Write short notes on
a) The micro-organisms on the skin surface. (12)
b) The mechanism of transmission of sensation in myelinated nerve fibres. (7)
c) Filaggrin. (6)
[25]
4 a) Tabulate the differences between necrosis and apoptosis. (15)
b) Write short notes on methods that may be employed to detect infective organisms in formalin-fixed skin biopsy specimens. (10) [25]
25 March 2009 Paper II
1 Discuss
a) The regulation and physiological function of Vitamin D3. (15)
b) Anti-apoptotic proteins. (5)
c) Cell adhesion molecules. (5)
[25]
2 a) With the aid of a diagram describe the dermo-epidermal junction and its relevance to cutaneous disease. (18)
b) Write short notes on direct immunofluorescence testing. (7)
[25]
3 Below is an ultrastructure electron micrograph and a special stain of a cell in the epidermis.
Please study these pictures carefully and answer the questions under the following headings.
a) Identify the cell and give reasons for your answer. (5)
b) The embryology and special stains used to confirm this cell. (5)
c) The microanatomy and distinguishing features of this cell. (5)
d) The regional variation of this cell. (4)
e) The immunological function of this cell (4)
f) Disease states associated with abnormality and pathology of this cell. (2)
[25]
4 a) Discuss the hypersensitivity reactions and cite examples with reference to clinical dermatology. (15)
b) Discuss amyloid under the following headings: (10)
i) types
ii) ultrastructure
iii) specific stains used to identify amyloid
iv) clinico-pathological aspects of amyloid.
[25]
1 Write notes on
a) Heterotopic calcification. (18)
b) The basic principles of the polymerase chain reaction, giving examples of its possible diagnostic applications in dermatology. (7) [25]
2 Study the pictures below
Picture 1
Picture 2
Picture 3
Answer the following regarding the previous 3 pictures.
a) Identify the cells giving reasons for your answers. (5)
b) Discuss the special stains used to identify these cells. (5)
c) Describe the microanatomy of these cells. (5)
d) Discuss the immunological function of these cells. (5)
e) Discuss pathological states involving these cells. (5) [25]
3 Write notes on
a. The short-term effects of ultraviolet light on the skin. (10)
b. The regulation of wound healing by growth factors and cytokines. (10)
c. Tumour suppressor proteins. (5) [25]
4 Discuss
a) The role of viruses in the development of skin carcinoma. (10)
b) Folate metabolism and its relevance to methotrexate toxicity. (7)
c) The cutaneous response to a drop in core temperature. (8) [25]
25 August 2009 Paper I
1 a) Write short notes on apoptosis.
b) Compare hyperplasia and hypertrophy.
c) Discuss granulomatous inflammation and the possible causes.[25]
2 Make short notes on/describe the following
a) Embryogenesis of cutaneous lymphatics.
b) Microanatomy of the lip.
c) Anchoring filaments and plaques of the epidermis.
3 Discuss the biochemistry and physiology of
a) Transforming growth factor beta. (7)
b) Tumour necrosis factor alpha. (10)
c) Toll-like receptors. (8) [25]
25 August 2009 Paper I (3 hours)
4 a) Discuss small RNAs (MicroRNAs and short interfering RNAs), their functions and their roles in human development and disease.
b) Discuss the Th17 immune response.
c) Describe acantholysis and discuss the different mechanisms leading to it. (12) [25]
26 August 2009 Paper II (3 hours)
a) a) Tabulate the fate of a thrombus.(8)
b) Write short notes on type III hypersensitivity.(7)
c) Discuss the pathology of vasculitis. (10) [25]
b) Make short notes on/describe the following
a) Keratinization of nails. Diagrams may be useful.(12)
b) Non-keratinizing epidermal cells.(13) [25]
3 a) How does the skin protect against infections?(15)
b) Discuss the types and functions as well as the influence of age and gender on the distribution of subcutaneous adipose tissue.(10) [25]
4 a) Describe the innervation of the skin. Diagrams may be useful. (13)
b) Describe three (3) laboratory techniques that can be used to reveal nerve supply and sensory receptors in the skin. (12) [25]
27 August 2009, Paper III (3 hours)
1 a) Discuss photocarcinogenesis.(10)
b) Discuss protein folding, the abnormalities that can be found in this process and the role that it plays in cutaneous disease. (5)
c) Discuss the processes involved in photo-aging, the cutaneous results thereof and compare it to intrinsic aging of the skin. (10) [25]
2 Describe in detail, the embryological development, structure, distribution and functioning of eccrine and apocrine sweat glands and sebaceous glands. Comment on changes that occur in these glands during the human life cycle. [25]
3 Discuss the following
a) The formation and metabolism of Vitamin D3.
b) Tumour suppressor proteins. (8)
c) The difference between a mutation and a polymorphism. (4)
27 August 2009, Paper III (3 hours)
4 a) Whilst shaving his beard, Yogo accidentally cut his chin. Discuss processes leading to the healing of his bleeding chin. (15)
b) Discuss mechanisms of heat loss in the skin. (10)
23 March 2010 Paper I (3 hours)
1 Write short notes on
a) The host’s response and possible outcomes following inhalation of Mycobacterium tuberculosis organisms. (10)
b) The role of the neutrophil in acute inflammation. (5)
c) The pathogenesis of cutaneous squamous carcinoma. (10) [25]
2 Discuss
a) The effects of the human immunodeficiency virus on the immune system. (10)
b) The pathogenesis and possible outcomes of deep vein thrombosis. (7)
c) The formation of giant cells. (8) [25]
3 a) Describe the structure of a hair follicle. (12)
b) Define each of the following (6)
i) Anagen phase.
ii) Catagen phase.
iii) Telogen phase.
c) Describe the changes that take place in the scalp in a balding middle-aged individual. (7) [25]
4 a) Various barriers divide body fluid into compartments. Write extensive notes on the fluid compartments of the body. Also refer to the different barriers and their permeability properties. (12)
b) Briefly note the main differences in chemical composition of the different fluid compartments. (5)
c) Give an explanation for the development of local oedema. (8) [25]
24 March 2010, Paper II (3 hours)
1 a) Define apoptosis and necrosis explaining how the two processes differ. (15)
b) Discuss the various types of necrosis. (10) [25]
2 Discuss the pathophysiology of pruritus and its relevance to cutaneous disease. [25]
3 a) The synthesis and secretion of adrenocorticoids are controlled by the hypothalamic pituitary-adrenocortical axis
i) List the different components of the hypothalamic-pituitary-adrenocortical axis. (5)
ii) Explain the classic long-loop negative feedback regulation within this axis. (7)
b) The net effect of adrenocorticoids such as cortisol on metabolism is geared to protect the body against hypoglycaemia, as the name glucocorticoids suggests. List some metabolic processes that are stimulated by cortisol in this regard. (5)
c) Describe some mechanisms involved in the anti-inflammatory action of adrenocorticoids. (8) [25]
4 a) Draw and label a diagrammatic representation of a cross section through the nail. (10)
b) Describe the process of keratinisation in nails. (7)
c) Discuss the structure and function of a glomus body. (8) [25]
25 March 2010, Paper III (3 hours)
1 Discuss the type III hypersensitivity reaction with reference to the diseases and their target organs in which these reactions play a role. [25]
2 Write notes on four so-called “clear cells” that can be seen by light microscopy in the normal epidermis, under the following headings
a) Light microscopic appearance with H & E stain.
b) Special stains by which these cells can be visualised and identified.
c) Electron microscopic characteristics. [25]
3 Discuss the embryology of the epidermis from a single cell layer up to, and including, the third trimester of pregnancy. [25]
4 Write short notes on the following
a) Calcineurin. (5)
b) Cell adhesion molecules. (10)
c) Epidermal growth factor. (5)
d) Retinoid receptors. (5) [25]
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