• Chemically, lipid include compounds that yield------------- fatty acids on hydrolysis and -------------------------- that can combine with fatty acid to form ---------

A. protein, --- complex alcohols------ carbohydrateB. fatty acids, --- complex alcohols------ esterC. Carbohydrate, --- complex alcohols------ proteinD. All of the above are corrects.E. None of the above is correct.• 2- Apolipoproteins differ:A. in their primary, secondary, and tertiary structure.B. Physiochemical behavior C. Their function and distributionD. All of the above E. None of the aboveF. • 3- Which of the following is corrects for HDL Apolipoproetin ?A. Apolipoproetin A form the major proteins found in HDLB. They originate on liver or intestine or both.C. Apo B is the major protein found inHDL.D. A and BE. B and C

• 4- which of the following is/are correct/s for VLDLA. VLDL synthesized in and released from the liver.B. VLDL transports hepatic-synthesized triglycerides and cholesterol which called endogenous lipids.C. VLDL is absorbed from plant sources in the intestine.D. A and BE. A, B and C• • 8- Wilson’s disease is an inherited condition characterized byA. low blood level of the copper-binding protein ceruloplasminB. low blood level of the iron-binding protein ceruloplasminC. High blood level of the cholesterol-binding protein ceruloplasminD. A and BE. A and C• • The pathological stage of the echinococcus species is A. LarvaB. EggC. AdultD. A and bE. B and C•

• Echinococcus body composed ofA. Scolex, Neck, 3 segmentsB. Scolex, Neck, 10 segmentsC. Scolex, Neck, 1 segmentsD. Scolex, Neck, 30 segmentsE. None of the above• • Echinococcus granulosus Definitive Host include/s: A. Carnivores including dogs, wolvesB. Intermediate Host: Herbivores sheep and miceC. HumanD. A and BE. B and C• • Echinococcus granulosus infection throughA. Insect bite such as flyB. Animal bites such as dogsC. ingestion of eggsD. A and B

• Mycobacteria pathogenic for humans can be differentiated

A. speed of growth (all are slower than most other pathogens)

B. production of chromogenic pigments (in light, in dark, or none)

C. speed of growth (all are faster than most other pathogens) D. A and BE. B and C• • Different forms of Apo B protein is found in humans:A. Large B or B-100 synthesized in LiverB. Small B or B-48 synthesized in intestine.C. Medium B or B-75 synthesized in heartD. A and BE. A,B and C

Q # Answer Statements

300. of plant sterols is ingested but poorly absorbed

Almost 90% of the body cholesterol is synthesized by the liver and gut from simpler molecules particularly acetate.

Synthesized cholesterol is releazed into circulation for transport with specific apolipoproteins in complexes known as lipoproteins.

Polyunsaturated fatty acids have more than one double bond

F LDL form from the hepatic depletion of IDL by hepatic lipoprotein lipase in the liver

F HDL accumulates cholesterol and Apo E is rapidly transferred to IDL

F IDL is catabolized to VLDL.

T Chylomicrons Responsible for transporting dietary fat

F VLDL synthesized in and released from the stomach

T Familial Hybercholesrolemia is an inherited autosomal dominant gene.

T An apolipoprotein E variant is the only unequivocal genetic risk factor

Essay Questions• 1. Observation of more than or equal to (≥) 5mm reactivity of PPD

test mean________

2. WHat is the difference between Intermediate host, Definitive host, and Paratenic host

3. Infection can be acquired by various routes, mention five routes with example

4. The development of the Mycobacteria disease depends on the outcome of the battle between the TB and the specific cellular immune defenses.

Q1 - PPD Tuberculosis Skin Test Criteria

PPD = Purified Protein Derivative from M. tuberculosis

Q2 Answer• Symbiosis: A parasitic relationship which results in

great advantage to each other as compared to disadvantage.

• Obligate parasite: A parasite which is completely dependent upon the host.

• Pathogen: a parasite which is able to produce disease.

• Intermediate host: a host in which the intermediate stage of the parasite develops.

• Definitive host: a host is which sexual reproduction takes place or the adult form of the parasite resides.

• Paratenic host: a host which acts as a transporting agent for the parasite and in which parasites dose not undergo any development.

• Infection: refer to the presence of parasite in or on the tissue of the host.

• Infestation: presence of arthropods on the skin of the host.

• Incubation period: the time interval between the entrance of the parasite into host and the beginning of disease.

Q3, Answer- Mode of infection in parasite disease

• Infection can be acquired by various routes.1. Through animals :

A. pig : e.g. porktapewormB. Cat : e.g. toxoplasmosis

2. Autoinfection: threadworm 3. Water-borne: e.g. Amoebiasis, giardisis.4. Vector borne: e.g. mosquito (malaria)5. Contaminated food: Ascaris, Amoebiasis6. Vertical transmission: malaria, toxoplasmosis7. Penetration through skin: Hookworm, Schistosomiasis

Q4, Answer- Pathogenesis and clinical picture

• It is necessary to differentiate between primary and secondary tuberculosis (reactivation or postprimary tuberculosis)

• The clinical symptoms are based on reactions of the cellular immune system with TB antigens.

• Primary tuberculosis: In the majority of cases, the pathogens enter the lung in droplets, where they are phagocytosed by alveolar macrophages.

• TB bacteria are able to reproduce in these macrophages due to their ability to inhibit formation of the phagolysosome.

• Within 10–14 days a reactive inflammatory the TB bacteria move into the regional hilar lymph nodes, where they reproduce and stimulate a cellular immune response, which in turn results in clonal expansion of specific T lymphocytes and attendant lymph node swelling.

• The Ghon’s complex (primary complex, PC) develops between six and 14 weeks after infection.

• At the same time, granulomas form at the primary infection site and in the affected lymph nodes, and macrophages are activated by the cytokine MAF (macrophage activating factor).

• A tuberculin allergy also develops in the macroorganism.

• The development of the disease depends on the outcome of the battle between the TB and the specific cellular immune defenses.

• Postprimary dissemination: development of local tissue defect foci at other localizations, typically the apices of the lungs.

• Mycobacteria may also be transported to other organs via the lymph vessels or bloodstream and produce dissemination foci there.

• The host eventually prevails in over 90% of cases: the granulomas and foci fibrose, scar, and calcify, and the infection remains clinically silent.

Secondary tuberculosis• About 10% of infected primary tuberculosis persons the reactivates to

become an organ tuberculosis, either within months (5 %) or after a number of years (5 %).

• Exogenous reinfection is rare in the populations of developed countries.

• Reactivation begins with a caseation necrosis in the center of the granulomas (also called tubercles) that may progress to cavitation (formation of caverns).

• Tissue destruction is caused by cytokines, among which tumor necrosis factor a (TNFa) appears to play an important role.

• This cytokine is also responsible for the cachexia (wasting syndrome is loss of weight, muscle atrophy) associated with tuberculosis. Reactivation frequently stems from old foci in the lung apices.

Secondary tuberculosis• About 10% of infected primary tuberculosis persons the reactivates to

become an organ tuberculosis, either within months (5 %) or after a number of years (5 %).

• Exogenous reinfection is rare in the populations of developed countries.

• Reactivation begins with a caseation necrosis in the center of the granulomas (also called tubercles) that may progress to cavitation (formation of caverns).

• Tissue destruction is caused by cytokines, among which tumor necrosis factor a (TNFa) appears to play an important role.

• This cytokine is also responsible for the cachexia (wasting syndrome is loss of weight, muscle atrophy) associated with tuberculosis. Reactivation frequently stems from old foci in the lung apices.