tus2010e - İngilizce Testi ve Cevap Anahtarı

8/8/2019 tus2010e - ngilizce Testi ve Cevap Anahtar

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Bu testlerin her hakk sakldr. Hangi amala olursa olsun, testlerin tamamnn veya bir ksmnn Merkezimizin yazl izniolmadan kopya edilmesi, fotorafnn ekilmesi, herhangi bir yolla oaltlmas, yaymlanmas ya da kullanlmas yasaktr. Buyasaa uymayanlar gerekli cezai sorumluluu ve testlerin hazrlanmasndaki mali klfeti peinen kabullenmi saylr.

T.C. YKSEKRETM KURULU

YERLETRME MERKEZ

S Y MRENC SEME VE

ADI

SOYADI

T.C. KMLK NUMARASI

SALON NUMARASI

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: .................................................

: .................................................

: .................................................

TIPTA UZMANLIK ETM GR SINAVI(SONBAHAR DNEM)

11 ARALIK 2010

YABANCI DL SINAVI

NGLZCE

A

G E N E L A I K L A M A

1. Bu snavda her adaya bir cevap kd ve bir sorukitap verilecektir. Soru kitapnzn kapandakiilgili yerlere adnz, soyadnz, T.C. Kimlik Numara-nz ve salon numaranz yazmay unutmaynz.

2. Bu snavda A ve B olmak zere iki tr soru kitapvardr.

3. Bu soru kitapnn tr Adr. Bunu cevap kdnz-daki ilgili alana kodlaynz. Salon grevlileri tarafndanparaflanmasn salaynz.

Bu kodlamay cevap kdnza yapmadnz ve-ya yanl yaptnz takdirde, snavnzn deer-lendirilmesi mmkn deildir.

4. Busoru kitapndaki test 100 sorudan olumaktadrve verilen cevaplama sresi 120 dakikadr (2 saat).

5. Bu kitapktaki sorularn cevaplar, kitapkla birlikteverilen cevap kdnda ayrlm olan yerlere, kurunkalemle iaretlenecektir. Cevap kd buruturul-mayacak, zerine gereksiz hibir iaret konmayacak-tr.

6. Bu kitapktaki her sorunun sadece bir doru cevabvardr. Bir soru iin birden fazla cevap yeri iaretlen-mise o soru yanl cevaplanm saylacaktr.

7. Bu snavn deerlendirilmesi doru cevap says ze-rinden yaplacak, yanl cevaplar dikkate alnmaya-caktr. Bu nedenle, her soruda size en doru gr-nen cevab iaretleyerek cevapsz soru brakmama-nz yararnza olacaktr.

8. Testi cevaplamaya istediiniz sorudan balayabilir-siniz. Bir soru ile ilgili cevabnz, cevap kdnda osoru iin ayrlm olan yere iaretlemeyi unutmaynz.

9. Snavda uyulacak dier kurallar bu kitapn arkakapanda belirtilmitir.


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2010 - TUS Sonbahar / NG

Dier sayfaya geiniz.

A 1

1. 5. sorular aadaki paraya grecevaplaynz.

Intracerebral hemorrhage (ICH), although accountingfor only 15% of acute strokes in the United States,carries the worst prognosis of all acutecerebrovascular diseases. Lobar ICH location(selective involvement of the cerebral cortex andunderlying white matter) is associated with greaterrisk for recurrence than deep ICH location and isassociated with different clinical features and riskfactors. Nonfamilial cerebral amyloidal antipathy(CAA), caused by -amyloid deposition in cerebralarteries and arterioles, is a major cause of lobar ICHbut not deep ICH, as shown by autopsyinvestigations as well as studies linking lobar ICHwith several hallmarks of CAA, such as the APOE 2and 4 alleles, asymptomatic microbleeds detectedon gradient-echo MRI, and white matter lesions.Based on recent evidence, there is some suggestionthat asymptomatic CAA may be highly prevalent inthe elderly. Although several predictors of lobar ICHrecurrence have been described, little is knownregarding the relative contribution or interaction ofeach of these predictors.

1. Parada, intraserebral kanama ile ilgili olarak aa-dakilerden hangisinden sz edilmemektedir?

A) Akut inmelerin yzde on beini oluturur.

B) Risk etkenleri ve klinik belirtiler asndan derin-de oluan ve lobar tipi farkldr.

C) Serebrovaskler hastalklar iinde prognozu enkt olandr.

D) Lobar tipte olanda tekrarlama riski daha yksek-tir.

E) Her ya grubunda grlebilir.

2. Parada, yallarla ilgili olarak aadakilerdenhangisinden sz edilmektedir?

A) Risk etkenleri ok daha fazladr.

B) Baz aleller intraserebral kanamaya yatknlkoluturur.

C) Belirtisiz serebral amiloid anfiopati daha sk g-rlebilir.

D) Derin intraserebral kanamaya -amyloid birikimineden olabilir.

E) ntraserebral kanamann tekrarlanma olaslyksektir.

3. Parada, intraserebral kanamann tekrarlamasylailgili belirtilerin hangi ynnn az bilindii sy-lenmektedir?

A) Tipleri veya zellikleri

B) Ortaya k nedenleri

C) Katk veya etkileimleri

D) Grlme sklklar

E) Etkileri veya nemleri

4. Parann birinci cmlesinde geen accountingfor ifadesinin Trke karl aadakilerdenhangisidir?

A) Oluturan B) Gelitiren

C) Belirtilen D) Hesaplanan

E) llen

5. Parann drdnc cmlesinde geen recentevidence ifadesininTrke karl aadaki-lerden hangisidir?

A) Yeni yaklam B) Genel kan

C) Gvenilir veri D) Gncel kant

E) Eldeki bulgu


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A 2


Inherited leukodystrophies are diseases of the

myelin, including abnormal myelin development,hypomyelination, or degeneration of myelin.Leukodystrophies are distinguished from the moregeneral term leukoencephalopathy, used to describeany disease of white matter, including also acquiredor toxic diseases of white matter. Recognition ofleukodystrophies has been revolutionized bymagnetic resonance technology because of itsincreased sensitivity compared to CT, and becauseof its ability in some cases to reveal disease-specificfeatures that can lead to a diagnosis. Disappointingly,however in almost half of leukodystrophy patients afinal diagnosis cannot be determined. Treatmentoptions for leukodystrophies are limited, and exist

chiefly for X-linked adrenoleukodystrophy,metachromatic leukodystrophy, Krabbe disease andsome lysosomal diseases. Characterization andtreatment of leukodystrophies has been hampered bythe failure to diagnose many patients, a lack ofclinical outcomes data (such as morbidities andmortality), and no data on overall incidence or relativefrequencies of different leukodystrophies. Incidencehas been estimated in a very broad range from1:5,000 to 2:100,000 live births.

6. Paraya gre, manyetik rezonans grntlemetekniinin stnl aadakilerden hangisidir?

A) Gvenirlilii B) Hassasiyeti

C) Kolay uygulanabilirlii D) Yaygnl

E) Kullanm kolayl

7. Parada, hayal krklna neden olduu sylenenaadakilerden hangisidir?

A) Lkodistrofi ile lkoensefalopatinin ayrmndakiglkler

B) Myelin dejenerasyonunun hereye ramen dur-durulamamas

C) Hastala zg deiimlerin kolaylkla saptana-mamas

D) Tedavi seeneklerinin olduka snrl olmas

E) Lkodistrofi hastalarnn hemen hemen yarsndatan konulamamas

8. Parada, lkodistrofilerin tanmlanmas ve teda-visindeki engellerle ilgili olarak aadakilerdenhangisinden sz edilmemektedir?

A) Birok hastaya tan konulamamas

B) Morbidite ve mortalite ile ilgili verilerin olmamas

C) Farkl lkodistrofilerin oransal skl ile ilgili veriyokluu

D) Hastalarn ge dnemde bavurmalar

E) Lkodistrofi eitlerinin toplam sklnn bilinme-mesi

9. Parann ilk cmlesinde geen distinguishedfrom ifadesinin Trke karl aadakilerdenhangisidir?

A) Ayrt edilir B) Deerlendirilir

C) Kabul edilir D) Benzetilir

E) Kartrlr

10. Parann son cmlesinde geen has beenestimated ifadesinin Tre karl aada-kilerden hangisidir?

A) Saylmtr B) Tahmin edilmitir

C) Tespit edilmitir D) Kararlatrlmtr

E) Tekrarlanmtr


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A 3


Distal myopathies are a genetically heterogenous

group of inherited muscle disorders characterized bythe preferential involvement of the distal limbmuscles. The genetic defect has been recognized inmore than 15 entities, evidencing that different genedefects can cause similar phenotypes whilemutations in the same gene may result in differentclinical profiles. This occurs with mutations in theslow -myosin heavy chain (MYH7) gene, whichcause familial hypertrophic/dilated cardiomyopathy,Laing distal myopathy, and myosin storage/hyalinebody myopathy. It has been postulated that theresulting phenotype depends on the location of themutation in the MYH7 gene. Laing myopathy is anearly-onset autosomal dominant disease

characterized by initial weakness of big toe extensorsand ankle dorsiflexors muscles. Nine mutationsbetween exons 32 and 37 in the rod domain ofMYPH7 have been reported. Beyond this region, 2mutations also cause distal myopathy, but they are,in addition, associated with cardiomyopathy. Differentstudies reported phenotypic variability in Laingmyopathy regarding proximal muscle involvement orcardiomyopathy. Pathologic features are alsovariable and nonspecific. As a result, the clinicalpicture is not fully delineated and neither themorphologic nor biologic clues suggesting thepathogenic pathyways underlying this disorder areclear.

11. Parada, aadakilerden hangisini destekleyenkantlar olduundan sz edilmektedir?

A) Bir gende birden ok mutasyon olabilir.

B) Distal myopatilerin genetik sebepleri vardr.

C) Ayn gendeki mutasyonlar benzer klinik belirtilerverir.

D) Sonuta, grlen belirtiler gendeki mutasyonunyerine baldr.

E) Farkl gen bozukluklar benzer fenotiplere nedenolabilir.

12. Parada, Laing myopati ile ilgili olarak aadaki-lerden hangisinden sz edilmemektedir?

A) Otozomal dominant tiptedir.

B) Erken dnemde ortaya kar.

C) Ayak baparmanda zayflkla tanmlanr.

D) MHY7 genindeki mutasyonlar dier genlerdekimutasyonlarla ayn klinik bulguyu verir.

E) Patolojik zellikleri eitli ve zgn deildir.

13. Parada, aadakilerden hangisinin tmyle a-a karlmad sylenmektedir?

A) Klinik tablonun

B) Kas tutulumunun orannn

C) Aile yksnn

D) Kaltmn etkisinin

E) Mutasyonun etkilerinin

14. Parann drdnc cmlesinde geen it has been

postulated ifadesinin Trke karl aadaki-lerden hangisidir?

A) Dayandrlmtr B) Saptanmtr

C) Varsaylmtr D) Balanmtr

E) Anlalmtr

15. Parann yedinci cmlesinde geen beyond thisregion ifadesinin Trke karl aadakilerdenhangisidir?

A) Btn bunlarn tesinde

B) Belirli bir ksmnda

C) Bu alann gerisinde

D) Bu blgenin ilerisinde

E) Bu blgeyi kapsayan


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A 4


Inflammatory and immune responses within the

central nervous system (CNS) significantly affect theclinical presentation and outcome of brain disorders,including stroke, trauma, Alzheimers disease,Parkinsons disease, epilepsy, encephalomyelitis andmultiple sclerosis. In the case of MS and its animalmodel experimental autoimmune encephalomyelitis(EAE), a classical inflammatory diseasecharacterized by cellular influx demyelination andaxonal damage of the CNS, initiation of disease iscontrolled by an interplay between cells of the innateand adaptive immune systems. Natural killer (NK)cells are an important cell subset of the innateimmune system represented by large granularlymphocytes that respond rapidly to a variety of

insults with cytolytic activity and cytokine secretion.Recently there has been a growing understanding ofNK cells, particularly with regard to their roles inautoimmunity in the joints, pancreas, and CNS.Mechanisms by which NK cells could have an impacton autoimmune responses include a rapid cytokinerelease by NK cells before autoreactive hepler T celldifferentiation and modulation of interactions betweenautoreactive T cells, B cells and antigen presentingcells (APCs). However, much of this evidence isderived from studying peripheral lymphoid organs.Whether NK cells can act in target organs ofautoimmunity such as the CNS has not yet beeninvestigated. The manifestations of CNS disease,such as MS and EAE, require the homing of

myelinreactive T cells to the CNS where T cellsundergo reactivation, further differentation andexpansion.

16. Parada, merkezi sinir sistemindeki yang ve

baklk cevaplarnn aadaki hastalklardanhangisinin belirtilerini ve sonucunu etkilediin-den sz edilmemektedir?

A) Alzheimer B) ok

C) Ensefalomyelit D) nme

E) Epilepsi

17. Parada, otoimmn ensefalomiyelitle ilgili olarakaadakilerden hangisinin doal ve kazanlmbaklkla kontrol edildii sylenmektedir?

A) Balamasnn B) lerlemesinin

C) iddetlenmesinin D) Gelime hznn

E) Belirtilerinin

18. Parada, NK hcrelerinden sitokin salnmasnnnasl olduu sylenmektedir?

A) Etkili B) zgn C) iddetli

D) Takip edici E) Hzl

19. Parada, elde edilen kantlarn ounun aada-kilerden hangisinde allarak bulunduu sylen-mektedir?

A) Merkezi sinir sisteminde

B) Periferal lenfoid organlarda

C) NK hcrelerinde

D) B hcrelerinde

E) Antijen sunan hcrelerde

20. Parada, myeline tepkili T hcrelerinin merkezisinir sisteminde aadakilerden hangisini ger-ekletirdiklerinden sz edilmemektedir?

A) Yerlemeyi B) Yeniden uyarlmay

C) leri farkllamay D) Yaylmay

E) Salg yapmay


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A 5


The endothelium provides an antithrombotic interface

with circulating blood which is generated in part bythe coordinated expression of endothelial-derivedanticoagulants. The regulated expression of theseendothelial-derived proteins may account in part fordifferences in thrombotic phenotype among vessels.Tissue factor pathway inhibitor (TFPI) is a Kunitz-typeserine protease inhibitor expressed in endothelialcells and regulates the initiation of coagulation byinhibiting tissue factor (TF)/factor VIIa activation offactor x. TFPI, originally known as lipoproteinassociated coagulation inhibitor, was isolated from ahepatoma cell line. TFPI circulates at low levels inhumans largely associated with lipoproteins. Infusionof heparin increases circulating levels of TFPI in

humans and this increase has been attributed todisplacement of TFPI from glycosoaminoglycans onthe surface of endothelial cells. As such, theendothelium has been thought to be the dominantsource of circulating TFPI. However, TFPI is alsoexpressed in platelets, vascular smooth musclecardiac myocytes and monocyte/macrophages. Thephysiologic importance of TFPI is confirmed in thatno known human deficiencies of TFPI have beenreported. Homozygotic deletion of exon 4 in micewhich encodes the Kunitz 1 domain resulted inembryonic lethality. Heterozygotic deletion results inan increased response to acute and chronic vascularinjury. Conversely, vascular directed overexpressionof TFPI attenuates this response.

21. Parada, endotelin aadakilerden hangisini sa-ladndan sz edilmektedir?

A) Koruma B) Dzlem

C) Ara yzey D) eper

E) rt

22. Parada, TFPI ile ilgili olarak aadakilerden han-gisinden sz edilmemektedir?

A) Heparinin kandaki miktarn azaltr.

B) Hepatoma hcrelerinden elde edilmitir.

C) Proteaz inhibitrdr.

D) Balangta lipoprotein ilikili phtlama inhibi-tr olarak biliniyordu.

E) Dolamda azdr ve ounlukla lipoproteinlerebal olarak bulunur.

23. Parada gre, aadakilerden hangisi fare embri-yolarnn lmne neden olmutur?

A) TFPInn fazla olmas

B) Drdnc eksonun homozigot biiminde kayb

C) Heterozigot biiminde TFPI geninde bozukluk

D) Damar zedelenmeleri

E) TFPInn oluturulmas

24. Parada, TFPInn balca kaynann aadaki-lerden hangisi olduu dnlmektedir?

A) Kalp kas hcreleri

B) Plateletler

C) Endotel

D) Damar dz kas hcreleri

E) Monositler ve makrofajlar

25. Parann son cmlesinde geen Converselyszcnn Trke karl aadakilerdenhangisidir?

A) Tamamiyle

B) Ek olarak

C) Benzerekilde

D) Eit olarak

E) Tersine


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A 6


Aortic valve replacement has been shown to improve

the natural history of patients with severesymptomatic aortic valve disease. With the increasein the global population and improved access tohealth care, the number of aortic valve surgeriesworldwide is estimated to triple within the next 30years. So far, surgery remains the only effectivesolution for improvement of the natural history of thedisease however, survival after surgery is oftenworse than that is in the general population and thedegree of improvement seems to depend on the typeof aortic valve substitute used. Randomizedcontrolled trials are a robust way to enable rational,evidence-based decision making with respect to thechoice of valve substitute. Nevertheless, the long-

term outcomes (survival and quality of life) afterdifferent valve replacement procedures in patientswith aortic valve disease have been compared in onlya few randomised studies. Result of severalobservational studies have shown an excellentpattern of survival after autograft aortic rootreplacement (Ross operation) in adults that might beattributed to selection bias.

26. Parada, aadakilerden hangisinin katnaktndan sz edilmektedir?

A) Aort kapak ameliyatlar

B) Salk destei iin bavuranlar

C) Aort kapak bozukluu olgular

D) Kapak eitleri

E) Aort kk deiimine bal lmler

27. Paraya gre, ameliyat sonras dzelmenin dere-cesi aadakilerden hangisine baldr?

A) Hastaln iddetine

B) Ameliyat sresine

C) Hastann genel durumuna

D) Kullanlan malzemeye

E) Cerrahn baarsna

28. Paraya gre, aort kapa deiimi sonras uzunsreli sa kalm ile ilgili olarak yaplan az saydakialma aadakilerden hangi tiptedir?

A) Geriye dnk B) Rastgele

C) ok ynl D) Kontroll

E) Geni apl

29. Parann drdnc cmlesinde geen robustway ifadesinin Trke karl aadakilerdenhangisidir?

A) zlenecek rota B) Tek k

C) Etkin giriim D) Gerek zm

E) Salam yol

30. Parann son cmlesinde geen might beattributed to ifadesinin Trke karl aa-dakilerden hangisidir?

A) Gnderilebilir B) Sebep olabilir

C) likilendirilebilir D) Benzetilebilir

E) Sonulandrlabilir


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A 7


On the basis of evidence suggesting an association

between volume and outcome, some specialistservices such as cancer surgery, perinatal care,trauma, and paediatric cardiac surgery have beencentralized in the past few decades. Through theconcentration of skills in a few centres, centralizationmight improve clinical outcomes and enable cost-effective delivery of high-quality care; however, theneed for patients to travel increased distances toaccess specialist services particularly in acute carecould also compromise their outcomes. Intensivecare services for children have undergone substantialcentralization in the UK since the 1990s afterscientific discussion and a change in national policy.In addition to the establishment of regional paediatric

intensive care units (PICUs), specialist retrievalteams were set up to transport critically ill childrenfrom other hospitals. Although two-thirds ofadmissions are from within the same hospital, mostadmissions from other hospital are stabilized andtransferred to PICUs by specialist retrieval teams.Specialist retrieval teams are staffed by clinicianstrained in paediatric intensive care who are able toundertake interventions such as mechanicalventilation, invasive haemodynamic monitoring, anduse of vasoactive drugs. There is a paucity of dataabout the effect of the nationwide process ofcentralization on outcomes in critically ill childrenparticularly those transferred from distant hospitals.In adult critical care, although disagreement exists

about the value of centralization, results of studiesshow that patients transferred from communityhospitals to tertiary intensive care units (ICUs) had anincreased risk of mortality in hospital even afteradjustment for suggesting an adverse transfer effect.

31. Parada, sz edilen merkeziletirmede temelalnan veriler aadakilerden hangisine iaretetmektedir?

A) Hacim ve sonu ilikisine

B) Baz zellemi servislere ulalamadna

C) Ortak grlere sklkla gerek duyulduuna

D) Hastalarn yakn servisleri setiine

E) alanlarn yetersizliine

32. Parada, baz merkezlerde yeteneklerin younla-trlmasnn aadakilerden hangisini salayabi-leceinden sz edilmektedir?

A) Tedavide eitli olaslklar

B) Dk maliyetle yksek kalitede bakm

C) Tanda hz

D) Uzmanlar arasnda ibirliini

E) Ulam kolayln

33. Parada sz edilen ekiplerin zellikleriyle ilgili

olarak aadakilerden hangisinden sz edilme-mektedir?

A) Damar zerinde etkili ilalar kullanmak

B) Mekanik ventilasyon yapabilmek

C) Giriimsel hemodinamik grntleme yapabil-mek

D) ocuk hastalarn youn bakmnda eitilmi ol-mak

E) Farkl hastanelerden gelmek

34. Parada, verilerle ilgili olarak aadakilerdenhangisinin bulunduundan sz edilmektedir?

A) Geerlilik B) Yetersizlik C) eitlilik

D) Kararszlk E) Gvenirlilik

35. Parada, yetikin bakmyla ilgili olarak aadakikonulardan hangisinde fikir birlii olmadndansz edilmektedir?

A) Uzmanlam merkezlerin gereinde

B) Merkezilemenin deerinde

C) Youn bakm nitelerinin gerekliliinde

D) Hastann tanmasnn olumsuz etkilerinde

E) Risklerin belirlenmesinde


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A 8


The natural history of chronic obstructive pulmonary

disease (COPD) is punctuated by exacerbations acute worsening of smptoms. Exacerbationsappear to accelerate the decline in lung function thatcharacterizes COPD resulting in reduced physicalactivity, poorer quality of life and an increased risk ofdeath and they are also responsible for a largeproportion of the health care costs attributable to thisprevalent condition. Consequently, exacerbations areimportant outcomes in clinical trials and theirprevention is a key component of COPD-management strategies. Despite the importance ofexacerbations, we know relatively little about theirincidence, their determinants and their effects onpatients with COPD at various levels of severity.

Although exacerbations are generally considered tobecome more frequent as the severity of theunderlying COPD increases, the most reliablepredictor of exacerbations in an individual patientappears to be a history of exacerbations. There maytherefore be a phenotype of exacerbationsusceptibility that includes milder forms of COPD.However, this theory has not been adequatelyinvestigated because our current understanding ofCOPD exacerbations and their relationship todisease severity is based on large interventionstudies or multiple smaller studies that have usedvarying definitions of exacerbation.

36. Parada sz edilen hastalkta aadakilerdenhangisi hastaln alevlenmesinin sonularndanbiri deildir?

A) Akcier ilevlerindeki hzl azalma

B) Fiziksel aktiviteyi azaltma

C) Yaam kalitesini drme

D) lm riskinde artma

E) Hastaln tedavisinde gecikme

37. Paraya gre, bir hastada alevlenmelerin en g-venilir belirleyicisi aadakilerden hangisidir?

A) iddeti B) Skl C) yks

D) Etkileri E) Nedenleri

38. Parada sz edilen kronik obstrktif akcierhastalyla ilgili teori aadakilerden hangisidir?

A) Farkl dzeydeki hastalarda alevlenmenin etkisi-nin de farkl olaca

B) Hastalk iddetlendike alevlenmelerin artt

C) Alevlenmeler engellenirse hastaln tedavi edile-cei

D) Hastaln hafifeklini ieren bir alevlenmeyeyatknlk fenotipi olabilecei

E) Alevlenmelerin hastaln doal bir sonucu ol-duu

39. Parann ikinci cmlesinde geen appears sz-cnn Trke karl aadakilerden hangi-sidir?

A) Farkllar B) Grnr C) Benzetilir

D) iddetlenir E) Yanltr

40. Parann son cmlesinde geen has not been

adequately investigated ifadesinin Trke karlaadakilerden hangisidir?

A) Yeterince incelenmemitir

B) Tamamen aklanmamtr

C) Uygun biimde tasarlanmamtr

D) Gerekli biimde belirtilmemitir

E) Doru olarak saptanmamtr


11/25



A 9


Autism, a neuropsychiatric disorder with an onset

before 3 years of age, is characterized by impairedreciprocal communication and social interaction aswell as by restricted and stereotyped patterns ofinterests and behaviour. The definition can be furtherbroadened to include atypical autism, Aspergerssyndrome and pervasive developmental disorder nototherwise specified, to create a class of conditionscollectively referred to as autism spectrum disorders(ASDs). ASDs affect approximately 0.6-1.2% of thegeneral population, with a marked excess of boyscompared with girls of about 4:1. Multiple lines ofevidence have shown that autism has a large geneticcomponent. The prevalence of ASDs is increased to2-8% among siblings of affected individuals and the

concordance rates increase from 0% in same-sexdizygotic twins to 36-60% in monozygotic pairs. Thus,the heritability of autism is about 90%, making it themost heritable of the childhood onsetneuropsychiatric disorders. Despite the obviousimportance of genetic factors in autism development,the search for genes underlying susceptibility hasmet with limited success. A large number of l inkagestudies have been conducted and have identifiedpossible susceptibility loci on multiple chromosomes.Although there is not total concordance between thedifferent studies, certain regions, such as those onchromosomes 2, 3, 7, 11, 16, 17 and 19, have beenimplicated multiple times. Candidate gene studieshave been used as an alternative approach for

identifying variants increasing susceptibility to autism.

41. Parada, otizmin belirleyici unsurlar arasndaaadakilerden hangisi saylmamaktadr?

A) Sosyal etkileim bozukluu

B) letiim bozukluu

C) yandan nce ortaya kma

D) Kstl ve kalpsal ilgilenme ekli ve davran

E) Alglama bozukluu

42. Parada, otizm spektrum bozukluklaryla ilgili ola-rak aadakilerden hangisinden sz edilmemek-tedir?

A) Genetik bileeni olduu konusunda ok veri bu-

lunur.B) Erkek ocuklarda kzlara gre drt misli fazla g-

rlr.

C) Erkek ayr yumurta ikizlerinde, tek yumurta ikizle-rinden daha fazla grlr.

D) ocuklardaki nropsikiyatrik hastalklarn en ka-ltsal olandr.

E) Toplumun genelinde az grlr.

43. Parada, alternatif bir yaklam olarak aadaki-lerden hangisinin incelendiinden sz edilmekte-dir?

A) Aday genler B) Yatknlk

C) Kromozomlar D) Kz hastalar

E) Genetik balantlar

44. Paraya gre, otizme yatknln temelindeki gen-lerle ilgili aratrmalar iin aadakilerden hangi-si sylenmektedir?

A) Geriye dnk almalarla desteklenmitir.

B) almalar arasnda balant kurulmutur.

C) Baars kstl olmutur.

D) Birok aile incelenmitir.

E) Birok ilgili protein bulunmutur.

45. Parann ikinci cmlesinde geen can be furtherbroadened ifadesinin Trke karl aadaki-lerden hangisidir?

A) Yaygnlamas mmkn olabilir

B) leri boyutta incelenebilir

C) lerlemesi salanabilir

D) Geni anlamda aklanabilir

E) Daha fazla geniletilebilir


12/25



A 10


Embryo implantation represents the most critical step

of the reproductive process. It consists of a uniquebiological phenomenon, by which the blastocystbecomes intimately connected to the maternalendometrial surface to form the placenta that willprovide an interface between the growing fetus andthe maternal circulation. A large number of identifiedmolecular mediators have been postulated to beinvolved in the early feto-maternal interaction,including hormones, adhesion molecules, cytokines,growth factors, lipids and others. During pregnancy,the placenta produces a wide number of thesemolecules that play essential roles in theestablishment and maintenance of pregnancyadaptation of the maternal organism to pregnancy,

fetal growth, and development of the mechanismsinvolved in parturition. In this context, leptin hasemerged as an important player in reproduction, andin particular, a relevant role of leptin in implantationhas been proposed. Leptin, the product of the LEPgene, is a small nonglycosilated peptide of 146 aminoacid residues, firstly found to be secreted by adiposetissue, with the function of modulation of satiety andenergy balance. Actually, leptin can be considered asa multifunctional hormone that regulates not onlybody weight homeostasis but also thermogenesisangiogenesis, hematopoiesis, osteogenesis,chondrogenesis, neuroendocrine, and immunefunctions, as well as arterial pressure control. Strongevidence also implicated leptin in reproductive

functions, such as the regulation of fertility, ovarianfunction, oocyte maturation, embryo development,and implantation.

46. Paraya gre, aadakilerden hangisinden oksayda tanmlanan vardr?

A) Fetustan salglanan byme faktrlerinden

B) Erken dnemde fetus-anne etkileimlerini d-zenleyen molekllerden

C) Blastosist zerinde etkisi olan hormonlardan

D) Ya dokusunu oluturan etkenlerden

E) Damar geniletici maddelerden

47. Parada, leptinin aadakilerden hangisindeki i-leviyle ilgili gl deliller olduu sylenmektedir?

A) Atardamar basncnn kontrolndeki

B) Kan yapmndaki

C) Baklktaki

D) remedeki

E) Kemik yapmndaki

48. Parada, leptin ile ilgili olarak aadakilerdenhangisi sylenmemektedir?

A) LEP geninin rndr.

B) Kk bir peptittir.

C) Mideden salglanr.

D) nce ya dokudan salgland bulunmutur.

E) Tokluk ve enerji dengesini dzenler.

49. Parann ikinci cmlesinde geen intimatelyconnected ifadesinin Trke karl aada-kilerden hangisidir?

A) Skca bal B) ten yapk

C) leri dzeyde ilikili D) Aradan tutunmu

E) Yan yana dizilmi

50. Parann beinci cmlesinde geen hasemerged ifadesinin Trke karl aa-dakilerden hangisidir?

A) Gerekletirdi B) Olutu

C) Etkiledi D) nem kazand

E) Ortaya kt


13/25



A 11


Metabolic syndrome is defined as the presence of 3

of 5 the following cardiovascular risk factors: increasein triglyceride levels, decrease in HDL cholesterol,moderate fasting hyperglycemia, hypertension, andincrease in waist circumference. Individuals withcentral obesity have a higher prevalence of metabolicsyndrome. Because of its major role in thedevelopment of type 2 diabetes, atherogenicdyslipidemia, cardiovascular disease, some cancers,and nonalcoholic fatty liver disease, visceral obesityhas emerged as a leading cause of morbidity andmortality worldwide. Chronic overnutrition and/or animbalance between energy expenditure and energyintake favor excessive body fat accumulation.Although we now have considerable knowledge

concerning the pathways that lead to a state ofenergy imbalance favouring adiposity, much remainsto be elucidated. Although a strategy involving aprolonged and marked reduction in caloric intake andincreasing physical activiy is the mainstay of thecurrent treatment of metabolic disorders, theseimprovements are rarely achieved simultaneously inreal life. As a consequence, the aim of muchtranslational research is the development of newpharmacological strategies for the reduction ofcardiovascular risks associated with excessive fataccumulation. One physiological/pharmacologicalapproach to its treatment is to try to achieve anegative energy and fat balance.

51. Parada, aadakilerden hangisinin btn dn-yada morbidite ve mortalitenin nde gelen sebebiolduu sylenmektedir?

A) Hipertansiyonun

B) Viseral obesitenin

C) Kalp damar hastalklarnn

D) Kanserin

E) Diyabetin

52. Parada, aadakilerden hangisiyle ilgili birokeyin bilinmedii sylenmektedir?

A) Obezitenin diyabet oluumuna yol atyla

B) Kanserle beslenmenin ilikisiyle

C) Damar tkanmasnda lipitlerin rolyle

D) Enerji dengesinin salanmasnda kiisel farkllk-larla

E) Ya birikmesinin nedeniyle

53. Parada, aadakilerden hangisinin birok ara-trmann hedefi olduundan sz edilmektedir?

A) Metabolik dzensizlikleri dengelemek

B) Kalbi ve damarlar koruyucu ilalar bulmak

C) Karacier yalanmasn engellemek

D) Ar ya birikimine bal kalp damar riskleriniazaltmak

E) Kalp damar hastalklarnn sebeplerini tanmla-mak

54. Parann beinci cmlesinde geen considerableknowledge ifadesinin Trke karl aadaki-lerden hangisidir?

A) nde gelen sebep

B) Farkllaan sre

C) Dikkate deer bilgi

D) Balca ama

E) Ayrntl yaklam

55. Parann yedinci cmlesinde geen As aconsequence ifadesinin Trke karl aa-dakilerden hangisidir?

A) Sonu olarak

B) Buna ramen

C) Bununla birlikte

D) rnek olarak

E) Bunun haricinde


14/25



A 12


Migraine is a common neurological disorder that

affects up to 15% of the adult population indeveloped countries. It is characterized by episodic,often disabling headache, associated with sensory(aura), autonomic (nausea and vomiting) andcognitive symptoms. Although debatable, manyresearchers regard migraine as a disorder in whichCentral Nervous System (CNS) dysfunction plays apivotal part, with various parts of the trigeminalsystem necessary for expression of peripheralsymptoms. From this framework, several novelapproaches to migraine therapy have arisen. A gap-junction modulator was designed to block the putativeinitiator of migraine attacks the spreadingdepression. A randomized, double-blind, placebo-

controlled, multicentre study showed fewer auraepisodes for recipients of the modulator than in theplacebo group but no significant difference in themedian number of migrane headache days. Agonistsof specific serotonin receptors are currently deemedthe best acute migraine-specific treatment, and haveprovided relief to many patients: these drugs aregenerally well tolerated but are not withoutshortcomings.

56. Parada, migrenin hangi zelliinin tartlabilirolduu sylenmektedir?

A) Periferik belirtilerin nce ortaya kmas

B) Merkezi sinir sistemi tarafndan tetiklenmesi

C) Kusmann otonomik bir belirtisi olmas

D) Gelimi lkelerde daha yaygn olmas

E) Model sistemlerin yeterli bilgi salayabilmesi

57. Parada, migrenin hangi belirtisinden sz edilme-mektedir?

A) Bilisel belirtilerden B) Kusmadan

C) Mide bulantsndan D) Auradan

E) Terlemeden

58. Aadakilerden hangisi parada sz edilen a-lmay tanmlamaz?

A) Gncel B) Rastgele

C) ift-kr D) Plasebo kontroll

E) ok merkezli

59. Parada, serotonin reseptr agonisti ile ilgili ola-rak aadakilerden hangisi sylenmemektedir?

A) Yan etkileri yoktur.

B) Baz eksiklikleri vardr.

C) Birok hastaya iyi gelmitir.

D) Genellikle iyi tolere edilmitir.

E) Migrene zg tedavide en iyi olarak kabul edil-mitir.

60. Parann beinci cmlesinde geen putative

initiator ifadesinin Trke kar

l

aa

dakiler-den hangisidir?

A) Balca etki B) Varsaylan balang

C) Belirti oluturan D) Olas balatc

E) Dnlen odak


15/25



A 13


About 25 years of experience with induced

pregnancy has taught us how hormones controlendometrial receptivity to embryo implantation. Inparticular, exogenous oestradiol and progesteroneare sufficient for priming endometrial receptivity whenovaries are absent or non-functional. However,findings suggest that the endometrium is altered inwomen with endometriosis. These findings thereforequestion whether the endometrium is optimallyreceptive in endometriosis. Uterine production ofprostaglandins E2 and F2 is well known duringmenses. Increased manufacture of prostaglandin is atypical finding in dysmenorrhoea, a disorder thatsometimes responds to cyclo-oxygenase (COX)inhibitors. In endometriosis, alterations of

prostaglandin production in the eutopic endometriumhave been identified . These include activation ofcyclooxgenes2 (COX2) and prostaglandin E2manufactured by interleukin 1 and other cytokinesmade locally by developing macrophages. A key stepidentified in women with endometriosis is activation ofsteroidogenic factor 1. This transcription factorenables prostaglandin E2 to initiate expression ofCYP19A1 (coding for aromatase, the enzyme thattransforms testosterone into oestradiol) throughstimulation of CYPI19A1s type Ila promoter. Thisprocess ultimately leads to in-situ production ofoestradiol, which possibly disrupts peristaltic activityof the myometrium.

61. Parada sz edilen bulgularn aadakilerdenhangisini gsterdii sylenmektedir?

A) Hormon dzeylerinin dardan kontrol edilebile-cei

B) Endometrioziste hormonal deiimler olduu

C) Endometrioziste endometriyumun deitii

D) Endometriyumun hormon etkisiyle deitii

E) Embriyo geliiminde hormonlarn en nemli rolesahip olduklar

62. Parada, aadakilerden hangisinden sz edil-memektedir?

A) Gelimekte olan makrofajlar blgesel olaraksitokin salglarlar.

B) Siklooksijenaz 2 inhibitrleri menstrasyonu et-kileyebilir.

C) Endometrioziste prostaglandin olumasndadeiiklik olur.

D) Endometriozis olan kadnlarda steroidojenikfaktr 1 aktifleir.

E) Dismenorede prostaglandin sentezi azalr.

63. Paraya gre, aromataz aadakilerden hangisinioluturur?

A) Testosteron B) stradiol

C) Prostaglandin E2 D) nterlkin 1

E) Siklooksijenaz

64. Parann ikinci cmlesinde geen sufficient sz-cnn Trke karl aadakilerden hangi-sidir?

A) Etkili B) Gerekli C) nemli

D) Yeterli E) Geerli

65. Parann son cmlesinde geen possiblydisrupts ifadesinin Trke karl aa-dakilerden hangisidir?

A) Karmas olasdr B) Etkileyebilir

C) Muhtemelen bozar D) Deitirilebilir

E) Engelleyici olabilir


16/25



A 14


The 5-year survival rate of all lung cancer patients is

only approximately 15%. Roughly 90% of all cancerdeaths are caused by metastatic disease, which isalready present in the majority of non-small cell lungcancer (NSCLC) patients at diagnosis. There is nostandard screening or prevention strategy for formersmokers, who remain at a high risk for NSCLC.Researchers have recently discovered that thereceptor tyrosine kinase EphA2 is expressed in morethan 90% of NSCLC but not significantly in normallung tissue, suggesting that it may be a moleculartarget for treatment or prevention. The Eph family ofreceptors is the largest group of receptor tyrosinekinases identified to date, having 14 family membersin mammals. Eph receptors and their ligands regulate

diverse cellular processes including axon guidance,angiogenesis, and embryonic patterning. Ephreceptors are classified into two subfamilies, A and B,based on sequence similarity and ligand affinity. Likethe Eph receptors, their ligands, called ephrins (Eph-receptor family interacting proteins) are membranebound and divided into two subfamilies based on howthey are attached to the membrane. The A-typeephrins are attached to cell membranes via aglycosylphosphatidylinositol anchor, and the B-typeephrins contain a transmembrane domain. Ephreceptors are expressed in numerous tissue typesbut their expression tends to be highest in thenervous system and is higher in embryos than inadults. Overexpression of EphA2 has now been

reported in NSCLC and a number of other humancancers. Increased EphA2 expression frequentlycorrelates with a poor prognosis and likelycontributes to the development of the malignantphenotype.

66. Paraya gre, tan srasnda kk hcreli olma-

yan akcier kanserlerinin byk ounluundaaadakilerden hangisi grlr?

A) Sigara iicilii B) lm korkusu

C) Hlsizlik D) Nefes alma gl

E) Metastaz

67. Parada efrin reseptrleri ile ilgili olarak aada-kilerin hangisinden sz edilmemektedir?

A) Hcresel etkilerine gre iki gruba ayrlrlar.

B) Bugne kadar tanmlanan en geni

tirozin kinazgrubudur.

C) Memelilerde 14 yesi bulunur.

D) Damar oluumunda rol alrlar.

E) eitli hcresel ilemlerle dzenlerler.

68. Parada, efrinlerle ilgili olarak aadakilerdenhangisinden sz edilmektedir?

A) Yetikinlerde embriyoya gre daha fazla bulu-nurlar.

B) Zara bal olarak bulunurlar.

C) Tirozin kinaz etkileri vardr.

D) Az sayda hcre tipinde grlr.

E) En fazla sinir sisteminde yaygndrlar.

69. Parada, gemite sigara imi olanlarla ilgili ola-rak aadakilerden hangisi sylenmektedir?

A) Yeterli bir tarama program iindedirler.

B) Molekler belirteler yoluyla takip edilmelidirler.

C) Kk hcreli karacier kanseri % 15 oranndagrlebilir.

D) Sigaraya tekrar balamalar engellenmelidir.

E) Kk hcreli olmayan akcier kanseri riski tar-lar.

70. Parada sz edilen reseptrn artan ifadesisklkla aadakilerden hangisiyle ilikilidir?

A) Metastatik oluumlarla

B) Hcre oalmasyla

C) Kt prognozla

D) Reseptr-ligant ilikilerinin bozulmasyla

E) Hcre zarndaki deiimlerle


17/25



A 15


Infectious diseases pose a continuous disease

burden on humans, and many diseases withunknown etiology may be caused by unidentifiedviruses. Key to effectively counter the potential publichealth threat caused by emerging infectious diseasesrequires a systematic exploration of infectiousviruses. Diarrhea is a common cause of morbidityand mortality. In developing countries, the mortalityassociated with gastroenteritis has been estimated at3 to 5 million cases per year. In industrializedcountries although typically self-limited, diarrhealdiseases are a significant cause of morbidity amongall age groups. Most gastroenteritis cases inindustrialized countries are caused by viruses.However, the etiological cause of a large proportion

of diarrhea cases (up to about 40%) remainsunresolved. The implementation of new technologiesfor virus discovery, based on microarrays orsequence-independent amplification of nucleic acids,already resulted in identification of many previouslyunknown viruses, among which are several newhuman astroviruses in human stool samples.

71. Parada, aadakilerden hangisi morbidite vemortalitenin yaygn bir nedeni olarak belirtil-mitir?

A) Tanmlanmam virsler B) Gastroenterit

C) shal D) Enfeksiyon

E) Astrovirsler

72. Parada, ishal olgularnn byk blm hakkn-da aadakilerden hangisi sylenmektedir?

A) Daha ok ocuklarda grlr.

B) Bulacl

yoktur.

C) Endstrilemi lkelerde i kayb sebebidir.

D) Hastalk atele birlikte seyreder.

E) Etkeni akla kavumamtr.

73. Parada, yeni teknolojilerin uygulanmasnn aa-dakilerden hangisiyle sonulandndan szedilmektedir?

A) Gelimi lkelerde ishal olgularnn azalmasyla

B) Daha nce bilinmeyen virslerin tanmlanmasyla

C) Yeni gastroenterit etkenlerinin bulunmasyla

D) Nkleik asit dizilerinin belirlenmesiyle

E) Aratrmalarn yaygnlamasyla

74. Parann ilk cmlesinde geen continuous

disease burdenifadesinin Trke karlaadakilerden hangisidir?

A) Hastaln seyri

B) Hastalk sresinde art

C) Ar hastalk biimi

D) Srekli hastalk yk

E) Devam eden hastalk

75. Paran

n ikinci cmlesinde geen requires sz-cnn Trke karl aadakilerden hangi-sidir?

A) Gerektirir B) Kapsar

C) Sonulanr D) Aklar

E) Destekler


18/25



A 16


Visual function is directly dependent on the health of

a wide array of tissues that comprise the eye, whichare commonly implicated in both inherited andacquired ocular diseases. Many of these previouslyuntreatable diseases are proving amenable tointerventions from the growing field of ocular genetherapy. Specifically, recombinant adeno-associatedviral (rAAV) vector-mediated ocular gene therapy hasdemonstrated success in numerous in vitro, in vivo,and ex vivo preclinical models, and extensivepreclinical studies have culminated in the firstsuccessful ocular gene therapy clinical trial. Threeindependent phase I clinical trials have beenconducted to investigate the therapeutic potential ofrAAV-mediated gene therapy in Lebers congenital

amaurosis. Thus far, results from all three clinicaltrials have proven promising as some of the patientsenrolled in the study are experiencing markedimprovements in their vision.

76. Parada, grme ilevinin aadakilerden hangisi-ne bal olduundan sz edilmektedir?

A) Kaltsal hastalk olmamasna

B) Damarlarla ilgili sorun olmamasna

C) Gzn etrafndaki alanlarn dzgn almasna

D) Genel salk durumuna

E) Gz oluturan dokularn salna

77. Parada, okler gen tedavisiyle ilgili olarak aa-dakilerden hangisinden sz edilmemektedir?

A) Leberin konjenital amorozunda etkili olabilece-inden

B) Sadece kaltsal gz hastalklar iin uygulanabi-lecek olmasndan

C) tane faz 1 klinik deneme yrtlmesinden

D) Rekombinant virslerin tayc olarak kullanlma-sndan

E) Klinik ncesi ve klinik uygulamalarnn bulunma-sndan

78. Parada sz edilen almaya dahil edilen bazhastalarda aadakilerden hangisinin olutuun-dan sz edilmektedir?

A) Beklentilerinde art

B) Okler hastalk

C) Grmelerinde belirgin gelime

D) Ksa sreli iyileme

E) Gen tedavisinden ekinme

79. Parann ikinci cmlesinde geen amenable tointerventions ifadesinin Trke karl aada-kilerden hangisidir?

A) lgilenilmeyi bekleyen

B) Deiime hazr

C) Dzeltilmesi gereken

D) Giriimlere uygun

E) yiletirilmesi beklenen

80. Parann son cmlesinde geen promising sz-cnn Trke karl aadakilerden hangi-sidir?

A) mit verici B) Yararl C) Etkili

D) Uygulanabilir E) lgili


19/25


20/25



A 18


Alzheimer disease (AD), the most common

dementing disorder of late life, is now the sixthleading cause of death in the United States. Thecourse of the disease is lengthy, and there iscurrently no effective treatment. A definitive diagnosisof AD requires postmortem examination of braintissue for the presence of distinctive ADhistopathology, including neurofibrillary tangles andextracellular deposits of the -amyloid peptide (A) insenile plaques. Activation of microglia and astrocytes,induction of neuronal cell cycle events (CCEs) andregional cell loss are also observed. Understandingthe relationship between the variousneuropathological hallmarks of AD in the humanbrain has proven difficult because of a lack of

accurate diagnostic markers; the length of diseaseprogression and the considerable variation in theduration, severity, symptoms, age of onset, andclinical/pathological correlations. Microglia, theresident immune cells of the brain are found in ahighly activated state in close anatomical proximity tosenile plaques within the AD brain, where theysecrete numerous proinflammatory cytokines andchemokines. Recent studies using in vivo imaginghave demonstrated that microglia rapidly migrate tonewly formed A deposits in mouse models of ADand are capable of removing A fibrils. However, itremains to be determined whether neuroinflammatoryalterations also contribute to early steps in ADprogression. Retrospective epidemiological studiesindicate that chronic long-term treatment withnonsteroidal antiinflammatory drugs (NSAIDs)decreases the risk for developing AD, which suggeststhat neuroinflammation may play a pivotal role inearly disease processes. However, thus far,prospective clinical trials with multiple differentNSAIDs have failed to demonsrate significantbeneficial effects in individuals with existing cognitiveimpairments characteristic of AD. At present, thebiological mechanisms underlying the divergentresults obtained in the retrospective and prospectiveNSAID studies remain unclear.

86. Parada, Alzheimer hastalnn tansyla ilgili ola-rak aadakilerin hangisinin varlna bakldn-dan sz edilmemektedir?

A) Nrofibril dmlerinin

B) Beta amiloid peptit kalntlarnn

C) Blgesel hcre kaybnn

D) Mikroglialarn uyarlm olmasnn

E) Sinir hcrelerinde hcre dngsnn basklan-m olmasnn

87. Parada, Alzheimer hastalnn tansn gleti-ren etkenler arasnda aadakilerden hangisi sa-ylmamaktadr?

A) Balama yann ok eitli olmas

B) Doru tan belirtelerinin olmamas

C) Hastaln ilerlemesinin uzun srmesi

D) Erken belirtilerinin olmamas

E) Belirtilerinin ok farkllk gstermesi

88. Parada, Azheimer hastalnda mikroglialarndavranlaryla ilgili olarak aadakilerden han-gisi sylenmemektedir?

A) Senil plaklar yaknnda bulunurlar.

B) Enflamasyonu Alzheimer geliimine neden olur.

C) Uyarlm durumdadrlar.

D) Beynin yerleik hcreleridir.

E) ok sayda enflamasyonu uyaran sitokinler sal-glarlar.

89. Parada, steroid olmayan antienflamatuar ila-larn kullanmyla ilgili olarak aadakilerdenhangisinden sz edilmemektedir?

A) Alzheimere zg bilisel bozukluklar olanlarayararl olmamtr.

B) Uzun sreli kullanm hastaln gelimesi riskiniazaltr.

C) Etkisi nroenflamasyonun Alzheimerda tetikleyi-ci rol oynayabileceini iaret eder.

D) leriye dnk almalardan alnan sonularolumludur.

E) Yaplan almalarda alnan farkl sonularn al-tnda yatan biyolojik mekanizmalar anlalma-

mtr.

90. Parann sekizinci cmlesinde geen contributeszcnn Trke karl aadakilerden han-gisidir?

A) Katkda bulunur B) Etkinletirir

C) erir D) Neden olur

E) Eklenir


21/25



A 19


In muscular dystrophy, there is progressive loss of

muscle fibers and replacement by fibroblasts andadipocytes, resulting in muscle weakness. Mutationsin the genes encoding dystrophin or its associatedproteins, the sarcoglycans, lead to a classical form ofdisease with early onset and a severe course.Mutations that disrupt dystrophin or the sarcoglycansrender the muscle plasma membrane fragile and leadto increased permeability. A leaky plasma membraneproduces elevated intracellular calcium and initiates acascade of proteolysis, cellular dysfunction and,ultimately, death of myofibers. As with mostmonogenetic disorders, there is phenotypic variabilityeven with an identical gene mutation. Age of onsetand ambulatory loss as well as targeted muscle

groups, are influenced by the precise geneticmutation in the dystrophin gene. However, evenwithin families where the same primary mutationoccurs, there is a range of disease severity. Therelated disorder limb girdle muscular dystrophy(LGMD) type 2C, arises from mutations in the geneencoding the dystrophin-associated protein -sarcoglycan. The frameshifting mutation causes theloss of y-sarcoglycon protein, and has beenassociated with variable outcome, ranging from asevere, early-onset, Duchenne-like phenotype to amilder disease course, with individuals remainingambulatory into their third and fourth decades. Theuniform genetic underpinning of this musculardystrophy underscores the presence of modifying

factors as major determinants of outcome. It is likelythat modifiers are equally important in DuchenneMuscular Dystrophy (DMD), but the large number ofmutations complicates the analysis of geneticmodifier loci.

91. Parada, kas plazma zarnn geirgenliini artr-masyla ilgili olaylar arasnda aadakilerdenhangisi saylmamaktadr?

A) Hcrede ilevsel bozukluk olumas

B) Protein ykm silsilesinin balamas

C) Hcre ii basncn artmas

D) Hcrede kalsiyum artmas

E) Sonunda kas liflerinin lmesi

92. Parada, distrofin geninde ayn mutasyonu ta-yan bir ailede hastaln hangi adan farkl oldu-u sylenmektedir?

A) Tedaviye yant

B) Belirti

C) Balama ya

D) Tutulum grlen kaslar

E) iddet

93. Paraya gre, genetik deitiricilerinincelenmesini aadakilerden hangisigletirmektedir?

A) Distrofin geninin ok byk olmas

B) Mutasyonlarn okluu

C) Birok genin etkisinin olmas

D) Genler aras eitliliin ok fazla olmas

E) ereve kaymas tipinde mutasyonlar bulunmas

94. Parann altnc cmlesinde geen as well asifadesinin Trke karl aadakilerdenhangisidir?

A) Baka bir deyile B) Karlk olarak

C) Benzerekilde D) Ayn zamanda

E) te yandan

95. Parann onuncu cmlesinde geen outcomeszcnn Trke karl aadakilerdenhangisidir?

A) Sonu B) Neden

C) liki D) Varsaym

E) karm


22/25



A 20


Hepatitis C virus (HCV) infection is pandemic

worlwide and long-term persistence of this virus isknown to cause liver cirrhosis. HCV infects about 3%of the world population. In some individuals, HCVinfection is self-resolving but does not providepermanent immunity. Most often, HCV infectionbecomes chronic, manifesting itself as chonichepatitis, liver carcinoma and cirrhosis. The antiviraltreatment choice for such individuals is a combinationtherapy with standart medications especially inunderdeveloped countries where the patients cannotafford the standard pegylated IFN therapy. It shouldbe noted that the response to IFN therapy dependson viral genotype as some viral strains are resistantto the treatment. In addition, even among patients

infected with the same genotype, the response to IFNtherapy is variable, indicating that some host geneticfactors such as interleuking (IL) 28B or humanleukocyte antigen (HLA) might be influencing thecilinical outcome of IFN therapy. A polymorphismnear IL28B is associated with the response to IFNtherapy for patients with chronic genotype 1 HCVinfection. In general, the host innate immuneresponse against HCV infection involves the releaseof type I IFNs (IFN- and -) followed by theactivation of many genes including cellular proteinasekinase R, MX proteins, RNA helicases and severalother antiviral factors. The cellular immune responseto HCV shows involvement of CD4+ T cells. This hasbeen shown in experiments on chimpanzees where

the animals that cleared virus more efficently showeda strong association with CD4+ T cells. Similarly, inhumans the involvement of CD4+ T cells has beenshown in response to interferon therapy.

96. Parada, hepatit enfeksiyonunun hangi durumdakalc baklk yapmad sylenmektedir?

A) Siroz gelitiinde

B) Kendiliinden iyilemede

C) Uzun sreli enfeksiyonlarda

D) Az gelimi lkelerde

E) nterferon tedavisi grmede

97. Parada, aadakilerden hangisi iin standartila tedavisinin zellikle bir seenek olduusylenmektedir?

A) Maddi durumu elverili olmayanlar

B) Genetik yaps uygun olanlar

C) Etkeni bilinen siroz olgular

D) Kronik karacier hastalar

E) Karacier karsinomu olanlar

98. Parada, interferon tedavisiyle ilgili olarakaadakilerden hangisine dikkat edilmesigerektiinden sz edilmektedir?

A) Polimorfizm zelliklerine

B) Enfeksiyonun sresine

C) Virsn genotipine

D) Aktive olan genlere

E) lgili proteinlere

99. Parada, aadakilerden hangisinin antiviraltedavinin etkili olmasn saladndan szedilmektedir?

A) nterlkin 28B B) CD4+ T hcreleri

C) LA antijeni D) RNA helikaz

E) MX proteinleri

100. Parann yedinci cmlesinde geen might be

influencing ifadesinin Trke karl aada-kilerden hangisidir?

A) Belirleyici olabilir B) Artrabilir

C) lgili olabilir D) Karabilir

E) Etkiliyor olabilir

TEST BTT.

CEVAPLARINIZI KONTROL EDNZ.


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SINAVDA UYULACAK KURALLAR

1. 2010-TUS Sonbahar Dnemi Snava Giri ve KimlikBelgesinin asl olmadan snava girilmesi yasaktr. Bubelgenin fotokopisi veya faks ile de snava girile-

meyecektir. Bu ekilde snava giren adaylarn snaviptal edilecektir.

2. Cep telefonu ile snava girmek kesinlikle yasaktr.ar cihaz, telsiz, fotoraf makinesi vb. aralarla;cep bilgisayar, kol ya da cep saati, her trl bilgisa-yar zellii bulunan cihazlarla; silah ve benzeri tehi-zatla; msvedde kd, defter, kitap, szlk, szlkilevi olan elektronik aygt, hesap cetveli, hesapmakinesi, pergel, aler, cetvel vb. aralarla dasnava girmek kesinlikle yasaktr. Bu aralarla snavagirmi adaylar mutlaka Salon Snav Tutananayazlacak, bu adaylarn snav geersiz saylacaktr.Snava kalem, silgi, kalemtra, saat vb. aralagirmek yasaktr. Kulaklk, kpe, bro vb. tak,

herhangi bir metal eya ile girmek de kesinlikleyasaktr. Yiyecek, iecek vb. tketim malzemeleride snava getirilemez. Adaylar snava effafieierisinde su getirebileceklerdir.

3. Bu snavda verilen toplam cevaplama sresi 120dakikadr (2 saat). Snav baladktan sonra ilk 90 veson 15 dakika iinde adayn snavdan kmasnakesinlikle izin verilmeyecektir.

4. Snav evrakn teslim ederek salonu terk edenaday, her ne sebeple olursa olsun tekrar snavaalnmayacaktr.

5. Snav sresince grevlilerle konumak, grevlileresoru sormak yasaktr. Ayn ekilde grevlilerin de

adaylarla yakndan ve alak sesle konumalar;ayrca, adaylarn birbirinden kalem, silgi vb. eyleriistemeleri kesinlikle yasaktr.

6. Snav srasnda, grevlilerin her trl uyarlarnauymak zorundasnz. Snavnzn geerli saylmas,hereyden nce snav kurallarna uymanza baldr.Kurallara aykr davranta bulunanlarn ve yaplacakuyarlara uymayanlarn kimlik bilgileri tutanaayazlacak ve snavlar geersiz saylacaktr.

7. Snav srasnda kopya eken, ekmeye kalkan,kopya veren, kopya ekilmesine yardm edenlerinkimlik bilgileri Salon Snav Tutanana yazlacak vebu adaylarn snavlar geersiz saylacaktr. Grev-

liler kopya ekmeye veya vermeye kalk

anlar

uyarmak zorunda deildir, sorumluluk size aittir.

Adaylarn test sorularna verdikleri cevaplarndalmlar bilgi ilem yntemleriyle incelenecek; buincelemelerden elde edilen bulgular bireysel veyatoplu olarak kopya ekildiini gsterirse, kopyaeylemine katlan adayn/adaylarn cevaplarnn birksm veya tamam iptal edilecektir. Cevap kdnzbakalar tarafndan grlmeyecek ekilde tutmanzgerekmektedir.

Snav grevlileri bir salondaki snavn, kurallara uy-gun biimde yaplmadn, toplu kopya giriimindebulunulduunu raporlarnda bildirdii takdirde,SYM takdir hakkn kullanarak bu salonda snavagiren tm adaylarn snavn geersiz sayabilir.

8. Cevap kadnda doldurmanz gereken alanlar bulun-maktadr. Bu alanlar doldurunuz. Cevap kdnayazlacak her trl yazda ve yaplacak btn iaret-

lemelerde kurun kalem kullanlacaktr. Snav sresibittiinde cevaplarn cevap kdna iaretlenmiolmas gerekir. Soru kitapna iaretlenen cevaplargeerli deildir.

9. Soru kitapnz alr almaz, sayfalarn eksik olupolmadn, kitapkta basm hatalarnn bulunupbulunmadn kontrol ediniz. Soru kitapnznsayfas eksik veya basm hatal ise deitirilmesiiin derhl Salon Bakanna bavurunuz. Sorukitapnn zerindeki aklamalar dikkatleokumadan cevaplama ilemine gemeyiniz.

Cevap kdnzda, size verilen soru kitapnntrn Soru Kitap Tr alanna iaretleyiniz.

Cevap kdnzda iaretlediiniz Soru KitapTr, salon grevlileri tarafndan snav ncesi kontroledilerek paraflanacaktr. Sizin iaretlediiniz ile salongrevlilerinin parafladklar kitapk tr arasnda farkolmas hlinde salon grevlilerinin parafladklarkitapk tr dikkate alnacaktr. Cevap kdndasoru kitap tr iaretlenmemi veya paraflan-mam adaylarn cevap ktlar kesinlikle deer-lendirmeye alnmayacaktr.

10. Cevaplamaya gemeden nce size verilecek sorukitapnn zerine adnz, soyadnz, T.C. KimlikNumaranz ve bu salonun Salon Numarasn yaznz.Snav sonunda soru kitapklar toplanacak ve

SYMde tek tek incelenecektir. Soru kitap

n

n birsayfas bile eksik karsa snavnz geersiz sayla-caktr.

11. Cevap kadna ve soru kitapna yazlmas veiaretlenmesi gereken bilgilerde bir eksiklik ve/veyayanllk olmas hlinde snavnzn deerlendirilmesimmkn olamamaktadr. Tarafnzdan yazlmas veiaretlenmesi gereken bu bilgilerde eksiklik ve/veyayanllk olmas hlinde durumunuz Snav SalonTutananda belirtilecektir.

12. Soru kitapnn sayfalarndaki bo yerleri msveddeiin kullanabilirsiniz.

13. Sorular ve/veya bu sorulara verdiiniz cevaplar ayrbir kda yazp bu kd dar karmanz kesin-likle yasaktr.

14. Snav salonundan ayrlmadan nce, soru kitap-nz, cevap kdnz, 2010-TUS Sonbahar DnemiSnava Giri ve Kimlik Belgenizi salon grevlilerineteslim etmeyi unutmaynz.

15. Yabanc Dil Snavnn sonular, 12 Aralk 2010Pazar sabahna kadar SYMnin, www.osym.gov.trinternet adresinden adaylara duyurulacaktr.


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Documents

tus2010e - İngilizce Testi ve Cevap Anahtarı