1. All of the following are true concerning the hormone Leptin EXCEPT [1]:

   A. Leptin is produced primarily by adipocytes (fat cells)
   B. Serum leptin levels correlate with weight
   C. Leptin causes fat breakdown in persons with normal weight
   D. Most obese patients have low levels of leptin
   E. Overweight persons treated with leptin have minimal decrease in weight

2. Which ONE of the following is true concerning leukocyte movement during inflammation [2] ?

   A. Monocytes enter inflamed areas first, followed by neutrophils then lymphocytes
   B. Leukocytes bind to endothelium in inflamed areas through random interactions
   C. Chemokines are specialized cytokines that stimulate directional movement of leukocytes
   D. Leukocytes enter normal and inflamed tissues in a stochastic manner
   E. Chemokines are very similar in structure to the inflammatory cytokines TNFa, IL1 and IL6

3. All of the following are true concerning dopamine's effects in the periphery EXCEPT [3]:

   A. In normal persons, low dose ("renal range", <3µg/kg/min) dopamine causes selective vasodilation of the afferent renal arterioles through D1 dopamine receptors
   B. Moderate dose ("cardiac range", 5-8µg/kg/min) dopamine causes increased inotropy and chronotropy through binding to ß1-adrenergic receptors in the heart
   C. High dose (>10µg/kg/min) dopamine causes progressive vasoconstriction through alpha1- adrenergic receptors in the vasculature
   D. The metabolism of dopamine in critically ill patients and normal volunteers is markedly different
   E. Renal range dopamine is protective against acute renal failure in patients in critical care settings

4. Which ONE of the following statements concerning the pathophysiology of sepsis is true [4] ?

   A. Host response patterns to inflammation play a minor or no role in outcomes in sepsis
   B. IL1ß and TNFa appear to be the most important early mediators in human sepsis
   C. Gram negative (lipopolysaccharide) bacterial products are the only major triggers of sepsis
   D. Proinflammatory, but not anti-inflammatory, cytokines, are overproduced in sepsis
   E. Polymorphisms in host cytokine genes have not yet been linked with outcomes in sepsis

5. All of the following concerning the HFE gene for hereditary hemochromatosis are true EXCEPT [5]:

   A. HFE protein is found in highest concentrations in duodenal enterocytes
   B. HFE is a class 1 MHC gene alpha chain that forms heterodimers with ß2-microglobulin
   C. HFE forms complexes with receptor for iron-binding transferrin
   D. HFE has lost the ability to bind peptides, unlike other Class 1 MHC genes
   E. HFE is directly involved in binding iron and carries across enterocytes

6. Glitazone (PPAR gamma agonist) agents are increasingly used for the treatment of type 2 diabetes mellitus and the insulin resistance syndromes (IRS). All of the following are nonhypoglycemic effects of glitazones that are potentially beneficial for the IRS EXCEPT [6]:

   A. Increase LDL levels
   B. Reduce triglycerides and increase HDL levels
   C. Decrease PAI-1 and fibrinogen levels
   D. Decrease in carotid artery intima-media thickness
   E. Increase LDL particle size and reduce LDL oxidation

7. All but ONE of the following is true concerning overexpression of the human epidermal growth factor receptor type 2 (Her2, also called Neu) in breast cancer [7]:

   A. Poorer long term prognosis
   B. Improved response to anthracycline (doxorubicin, daunorubicin, others) therapy
   C. Responsiveness to anti-her2/neu antibody (Herceptin®) therapy
   D. Associated with reduced S phase fraction
   E. Higher clinical stage of disease at initial diagnosis of breast cancer

8. Concerning the pathogenesis of asthma, which ONE of the following is true [8] ?

   A. Eosinophils can be eradicated with little effect on bronchial hyperreactivity
   B. Eosinophils stimulated by interleukin 5 production are necessary for asthma initiation
   C. High levels of interleukin 12 stimulate T helper type 2 cell mediated eosinophil production
   D. High levels of IgE in allergic asthma are due to overproduction of interleukin 1 and 5
   E. Chemokines such as interleukin 8 and eotaxin initiate leukocyte infiltration and bronchial reactivity

9. Which ONE of the following is true concerning nitric oxide (NO) [9]

   A. Derived from metabolism of nuceosides and nucleotides by nitric oxide synthetase (NOS)
   B. Superoxide + nitric oxide form peroxynitrite radicals which are toxic to endothelium
   C. Potent constrictor of smooth muscle including blood vessel, esophageal, bronchial
   D. Enhances platelet aggregation
   E. Two forms of NOS are found in humans

10. All of the following are properties of normal endothelium EXCEPT [10]:

    A. Derived from multipotent CD34+ hemangioblastic progenitor cells []
    B. Normal endothelium is antithrombotic, anti-inflammatory
    C. Produces both vasodilator (nitric oxide) and vasoconstrictor (endothelin) substances
    D. Interacts with both smooth muscle and leukocytes
    E. Normal endothelium permits atherosclerotic plaque generation

Answers

1. D
2. C
3. E
4. B
5. E
6. A
7. D
8. A
9. B
10. E