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1 The MCAT is Changing 1 LEARN ABOUT THE MCAT 2015 FROM THE EXPERTS Chris Hinkle Hannah Whitehead

2 Today’s Agenda 2 The MCAT Today The MCAT 2015 Which test is right for you? Sample Questions The Princeton Review Program & Approach Questions & Answers

3 The MCAT 3 MCAT  Medical College Admission Test Developed by AAMC (Assoc. of American Medical Colleges) If you want to go to medical school in the U.S. or Canada … almost all schools require you to take the MCAT

4 AAMC 4 Represents the United States medical schools and teaching hospitals Sets American agenda for medical education and research Manages the creation and administration of the MCAT worldwide The MCAT According to AAMC: ̶̶ Designed to assess problem solving, critical thinking, communication and writing skills ̶̶ Designed to assess examinee's knowledge of science concepts and principles prerequisite to the study of medicine

5 MCAT 2013-2015 2013 Elimination of the Writing Section and creation of a Trial Section. 2014 Elimination of Trial Section in October 2015 Last administration of the current MCAT in January First administration of the new MCAT 2015 in the Spring Includes the addition of a new section; Psychological, Social, and Biological Foundations of Behavior. 5

6 Multiple-choice, 4 choices per question (A-D) Passage-based and freestanding questions Scores based on number of questions correct No guessing penalty (Never leave a blank) MCAT Today Breakdown 6 MCAT Today SECTIONSCORE RANGE Physical Sciences1-15 Verbal Reasoning1-15 Biological Sciences1-15 Optional Trial Section% Correct Composite3-45

7 7 The MCAT Today MCAT Today FORMATMCAT IS EXCLUSIVELY COMPUTER-BASED Number of Questions52 Physical Sciences; 40 Verbal Reasoning; 52 Biological Sciences; 32 Optional Trial Section Total Content Time4 hours, 5 minutes (includes Trial Section) Total “Seated Time”5 hours, 10 minutes BreaksOptional breaks No lunch hour Frequency of Test25 testing days – 28 total administrations (additional days added for 2014) RegistrationAvailable up until the test week* Results Delivery30-35 days after your tests date and can be accessed through your AAMC account SecurityPhoto ID Electronic fingerprint Electronic signature verification Testing CentersSmaller, climate-controlled computer testing rooms with standardized proctoring * Note: many locations fill up much earlier

8 Your MCAT Today Testing Day 8 MCAT Today TEST SECTIONQUESTIONSTIME Tutorial (Optional)10 minutes Physical Sciences (7 Passages + 13 FSQ)5270 minutes Break (Optional)10 minutes Verbal Reasoning (7 Passages)4060 minutes Break (Optional)10 minutes Biological Sciences (7 Passages + 13 FSQ)5270 minutes Trial Section (Optional)3245 minutes Satisfaction Survey1210 minutes Total Content Time4 hours, 5 minutes Total “Seated Time”5 hours, 10 minutes Total Appointment Time (includes check-in) 5 hours, 30 minutes

9 Why is the test changing? The MCAT is undergoing its biggest change since 1991. To adjust to these changes, AAMC has worked closely with medical schools to assess the MCAT, keep what works, remove what isn’t working and to enhance the test to include concepts the next generation of doctors will need. The MCAT has been a passage based test since 1991 precisely to encourage reasoning. MCAT 2015 science sections are driven by changes in what med schools find most important and that the new psychology/sociology section is about recognizing additional factors in health and health outcomes. 9 MCAT 2015

10 What is changing? The test is longer 2 hours and 20 minutes more testing time 1 additional section 86 more questions More time per question (1:35 per science Q; 1:40 per CARS Q) Possibly an indication of increased need for reading comprehension The scores have changed Each section will be scored on a 118-132 point scale centered on 125. The composite score will range from 472-528 points centered on 500. This is similar to a 1-15 point score on each section and a 4-60 point composite score. 10 MCAT 2015

11 What is changing? 4 Sections instead of 3 and focus has shifted Chemical and Physical Foundations of Biological Systems This section will cover concepts in physics, general chemistry, organic chemistry, and biochemistry. It will test your knowledge of the basic physical and chemical principles inherent in the functions of the human body. This section will also test your ability to apply your knowledge of these general principles to living systems. Critical Analysis and Reasoning Skills This section will require you to analyze information from a wide variety of humanities-based disciplines. No prior content knowledge is required, and all questions will be answerable from the provided material. 11 MCAT 2015

12 What is changing? 4 Sections instead of 3 and focus has shifted Biological and Biochemical Foundations of Living Systems This section will cover concepts in biology, biochemistry, and organic chemistry. It will test your knowledge of the fundamental concepts governing the unique processes in living systems (growing, reproducing, responding, metabolizing, and adapting). At the same time, it will test your understanding of how cells, organs, and organ systems work together to accomplish these processes as well as your ability to reason about these processes. Psychological, Social, and Biological Foundations of Behavior This section will test concepts in psychology, sociology, and biology as how they apply to the socio-cultural and behavioral aspects of health and well- being. You will also be tested on research methods and statistics, and on your ability to apply your knowledge to understand how social and behavioral factors influence health. 12 MCAT 2015

13 Multiple-choice, 4 choices per question (A-D) Passage-based and freestanding questions Scores based on number of questions correct No guessing penalty (Never leave a blank) MCAT 2015 Breakdown 13 SECTIONSCORE RANGE Chemical and Physical Foundations of Biological Systems 118-132 Critical Analysis and Reasoning Skills 118-132 Biological and Biochemical Foundations of Living Systems 118-132 Psychological, Social, and Biological Foundations of Behavior 118-132 Composite 472-528 MCAT 2015

14 14 The MCAT 2015 FORMATMCAT 2015 IS EXCLUSIVELY COMPUTER-BASED Number of Questions59 Chemistry/Physics; 53 CARS; 59 Biology/Biochemistry; 59 Psychology/Sociology Total Content Time6 hours, 15 minutes Total “Seated Time”7 hours, 25 minutes BreaksOptional breaks Probable lunch break Frequency of Test14 testing days beginning 8 am (April-September 2015) RegistrationBegins in February 2015 Registration fee is $300 ($150 gift card for those registering for April 2015 test) Available up until the test week* Results Delivery30-35 days after your tests date and can be accessed through your AAMC account SecurityPhoto ID Electronic fingerprint Electronic signature verification Testing CentersSmaller, climate-controlled computer testing rooms with standardized proctoring * Note: many locations fill up much earlier MCAT 2015

15 Your MCAT 2015 Testing Day 15 TEST SECTIONQUESTIONSTIME Examinee Agreement10 minutes Tutorial (Optional)5 minutes Chemical and Physical Foundations of Biological Systems (9-10 Passages + 15 FSQ) 5995 minutes Break (Optional)10 minutes Critical Analysis and Reasoning Skills (9 Passages)5390 minutes Mid-Exam Break (Optional)30 minutes Biological and Biochemical Foundations of Living Systems (9-10 Passages + 15 FSQ) 5995 minutes Break (Optional)10 minutes Psychological, Social, and Biological Foundations of Behavior (9-10 Passages + 15 FSQ) 5995 minutes Void Question5 minutes Satisfaction Survey (Optional)5 minutes Total Content Time6 hours, 15 minutes Total “Seated Time”7 hours, 30 minutes Total Appointment Time (includes check-in) 7 hours, 45 minutes MCAT 2015

16 MCAT Today vs. MCAT 2015 16 TEST SECTIONMCAT TodayMCAT 2015 Total Content Time4 hours, 5 minutes6 hours, 15 minutes Total “Seated Time”5 hours, 10 minutes7 hours, 30 minutes SectionsPhysical Sciences Verbal Reasoning Biological Sciences Optional Trial Section (ends Oct 2014) Chemical and Physical Foundations of Biological Systems Critical Analysis and Reasoning Skills Biological and Biochemical Foundations of Living Systems Psychological, Social, and Biological Foundations of Behavior Section StructureScience Sections (70 minutes) 7 Passages + 13 FSQ Verbal Section (60 minutes) 7 Passages Trial Section (45 minutes) Science Sections (95 minutes) 9-10 Passages + 15 FSQ CARS Section (90 minutes) 9 Passages Number of Questions144 multiple choice (176 including optional Trial Section) 230 multiple choice Scoring1-15 Section Score x3 4-60 Composite Score % Correct on optional Trial Section 118-132 Section Score x4 472-528 Composite Score MCAT 2015

17 Take the MCAT Spring 2015 Apply to Medical School Ideally June 2015 (as late as September 2015 Attend Medical School Fall 2016 Final Chance for the MCAT Summer 2015 17 Which test is for you? Learn about the Test Changes Take a Psych & Soc course as electives, if you have time CLASS OF 2016 The Changes to the MCAT WILL Impact You Some flex room since there are a few current MCAT offerings in Jan 2015

18 Take the MCAT Spring 2016 Apply to Medical School Ideally June 2016 (as late as September 2016 Attend Medical School Fall 2017 Final Chance for the MCAT Summer 2016 CLASS OF 2017 The Changes to the MCAT WILL Impact You 18 Which test is for you? Learn about the Test Changes Take a Psych & Soc course as electives Learn about the Test Changes Take a Psych & Soc course as electives

19 Pulmonary respiration involves the transfer of gas across the alveolar septum into the alveolar capillaries. The steps in respiration include ventilation (moving gas into alveoli), diffusion of gas through the alveolar septum, and transportation of the gas within the blood. This process is used to maintain the partial pressures of oxygen and carbon dioxide at values approximating those in Table 1. The partial pressure of water in the alveoli is a function of body temperature, and therefore it essentially remains constant. Ventilation of the alveoli results from the contraction of inspiration muscles, including the diaphragm and intercostal muscles, which increases the volume of the thoracic cage. The lungs expand due to the negative pressure within the pleural cavity, the potential space between the surface of the lung and thoracic wall. Once air reaches the alveoli, it diffuses into the blood. Chemical and Physical Foundations of Biological Systems Sample Questions 19 Equation 1 Rate of diffusion of a gas across the alveolar septum

20 Chemical and Physical Foundations of Biological Systems Carbon monoxide is freely permeable across the alveolar septum, and is used to measure the diffusion capacity of lungs (D L ) since the partial pressure does not significantly increase within the blood. The diffusion capacity takes into account the surface area and thickness of the alveoli as well as the solubility and molecular weight of the gas. A single breath of a mixture of gases with a known partial pressure of carbon monoxide is inspired and held for 10 seconds. The partial pressure of carbon monoxide is then measured in the expired air, and the difference in partial pressures is used to measure the diffusion capacity of the lungs according to Equation 2. At rest, the diffusion capacity is normally 25 mL/min mm Hg Equation 2 20 Sample Questions

21 Chemical and Physical Foundations of Biological Systems 1. Which of the following statements about carbon monoxide movement in the lungs is most accurate? A. The movement of carbon monoxide across the alveolar septum is diffusion limited, and depends on the amount of blood flow through the lungs. B. The movement of carbon monoxide across the alveolar septum is diffusion limited, and is independent of the amount of blood flow through the lungs. C. The movement of carbon monoxide across the alveolar septum is perfusion limited, and depends on the amount of blood flow though the lungs. D. The movement of carbon monoxide across the alveolar septum is perfusion limited, and is independent of the blood flow through the lungs. 21 Sample Questions

22 Chemical and Physical Foundations of Biological Systems 1. Which of the following statements about carbon monoxide movement in the lungs is most accurate? A. The movement of carbon monoxide across the alveolar septum is diffusion limited, and depends on the amount of blood flow through the lungs. B. The movement of carbon monoxide across the alveolar septum is diffusion limited, and is independent of the amount of blood flow through the lungs. C. The movement of carbon monoxide across the alveolar septum is perfusion limited, and depends on the amount of blood flow though the lungs. D. The movement of carbon monoxide across the alveolar septum is perfusion limited, and is independent of the blood flow through the lungs. B. A gas which is diffusion limited has an essentially constant partial pressure gradient despite changes in capillary blood flow. In this case, the transfer of gas into the blood depends only on how fast it crosses the alveolar septum. When a gas is perfusion limited, the partial pressure in the blood quickly rises to equal that within the alveoli, and the partial pressure gradient is lost. In that case, gas transfer depends only on how fast the blood moves through the capillary because it is essentially always saturated. These facts eliminate choices B and C. From Figure 1, the partial pressure of carbon monoxide does not rise significantly within the blood. The passage of CO into the blood depends strictly on how easily it diffuses across the septum and not by the amount of blood flowing through the pulmonary capillaries. Therefore, choice A is eliminated and choice B is correct. 22 Sample Questions

23 Chemical and Physical Foundations of Biological Systems 2. Which of the following changes would increase the diffusion of a gas by the greatest amount? A. Double the solubility, double the alveolar thickness, and quarter the molecular weight B. Halve the solubility, double the surface area, and increase the molecular weight by a factor of four C. Double the solubility, double the surface area, and double the molecular weight D. Double the alveolar thickness, half the molecular weight, and half the solubility 23 Sample Questions

24 Chemical and Physical Foundations of Biological Systems 2. Which of the following changes would increase the diffusion of a gas by the greatest amount? A. Double the solubility, double the alveolar thickness, and quarter the molecular weight B. Halve the solubility, double the surface area, and increase the molecular weight by a factor of four C. Double the solubility, double the surface area, and double the molecular weight D. Double the alveolar thickness, half the molecular weight, and half the solubility 24 Sample Questions

25 Chemical and Physical Foundations of Biological Systems 3. The correct order of steps involved in pulmonary ventilation is: A. contraction of inspiration muscles, decreased pressure in pleural space, increased lung volume, and ventilation of alveoli. B. contraction of inspiration muscles, decreased pressure in the pleural space, ventilation of alveoli, and increased lung volume. C. increased lung volume, contraction of inspiration muscles, decreased pressure in the pleural space, and ventilation of alveoli. D. contraction of inspiration muscles, increased lung volume, decreased pressure in pleural space, and ventilation of alveoli. 25 Sample Questions

26 Chemical and Physical Foundations of Biological Systems 3. The correct order of steps involved in pulmonary ventilation is: A. contraction of inspiration muscles, decreased pressure in pleural space, increased lung volume, and ventilation of alveoli. B. contraction of inspiration muscles, decreased pressure in the pleural space, ventilation of alveoli, and increased lung volume. C. increased lung volume, contraction of inspiration muscles, decreased pressure in the pleural space, and ventilation of alveoli. D. contraction of inspiration muscles, increased lung volume, decreased pressure in pleural space, and ventilation of alveoli. A. The passage states that ventilation results from contraction of inspiration muscles, making contraction the likely first step and eliminating choice C. When the thoracic cage is expanded. it simultaneously increases the volume and decreases the pressure of the pleural potential space. This eliminates choice D. The negative pressure within the pleural space causes lung volume to increase. As lung volume increases, lung pressure decreases and air rushes into the lung. Therefore, choice B can be eliminated, and choice A is correct. 26 Sample Questions

27 Chemical and Physical Foundations of Biological Systems NOTE: THIS IS A FREESTANDING QUESTION 2. Perspiration is important in maintaining normal body temperature. Compared to water at its boiling point, which of the following is true about water at normal human body temperature? A. More energy is required for gas expansion. B. Average kinetic energy is greater. C. Intermolecular forces are weaker. D. The heat required to vaporize is higher. 27 Sample Questions

28 Chemical and Physical Foundations of Biological Systems NOTE: THIS IS A FREESTANDING QUESTION 2. Perspiration is important in maintaining normal body temperature. Compared to water at its boiling point, which of the following is true about water at normal human body temperature? A. More energy is required for gas expansion. B. Average kinetic energy is greater. C. Intermolecular forces are weaker. D. The heat required to vaporize is higher. D. As water on the skin vaporizes it absorbs energy and cools the body. Temperature is a measure of average kinetic energy, so water has less average kinetic energy at 37°C compared to 100°C (eliminate B). Since it has less kinetic energy, the molecules interact with each other with stronger intermolecular forces (eliminate C). As temperature increases, water requires more and more energy to expand the volume of its gaseous phase (eliminate A). Although choice A might not be obvious to eliminate, choice D is a better answer. Water is much more likely to vaporize at its boiling point than at body temperature. It takes additional energy to go from the liquid to gas phase at lower temperatures. Therefore the heat required to vaporize is higher at lower temperatures. 28 Sample Questions

29 Chemical and Physical Foundations of Biological Systems NOTE: THIS IS A FREESTANDING QUESTION Sample Qs 29 Sample Questions

30 Chemical and Physical Foundations of Biological Systems NOTE: THIS IS A FREESTANDING QUESTION C. First we must calculate the flow rate through the aorta. To calculate flow rate, we use f aorta = A aorta × V aorta = 5 × 20 = 100 cm 3 /s. Since the aorta and the capillaries are in continuity with each other (or in series), and the capillaries are in parallel to each other, then by the continuity equation, f aorta = f cap = 100 cm 3 /s. Since the flow speed through the capillary is known, then the total area of the capillaries can be calculated. f cap = A capTotal × V cap, therefore 100 = A capTotal × 0.04, thus A capTotal = 2500 cm 2. If we divide total area of the capillaries by the area of an individual capillary, we can get the number of capillaries in the human body. A capTotal / A cap = 2500/(2.5 x 10 -7 ) = 10 10 = 10 x 10 9 = 10 billion. 30 Sample Questions

31 Critical Analysis and Reasoning Passage V (Questions 24-30) The question is often asked how individuals, having no right to dispose of their own lives, can transfer to the Sovereign a right which they do not possess. The difficulty of answering this question seems to me to lie in its being wrongly stated. Every man has a right to risk his own life in order to preserve it. Has it ever been said that a man who throws himself out of the window to escape from a fire is guilty of suicide? Has such a crime ever been laid to the charge of him who perishes in a storm because, when he went on board, he knew of the danger? The social treaty has for its end the preservation of the contracting parties. He who wills the end wills the means also, and the means must involve some risks, and even some losses. He who wishes to preserve his life at others' expense should also, when it is necessary, be ready to give it up for their sake. Furthermore, the citizen is no longer the judge of the dangers to which the law desires him to expose himself; and when the prince says to him: ‘It is expedient for the State that you should die; he ought to die, because it is only on that condition that he has been living in security up to the present, and because his life is no longer a mere bounty of nature, but a gift made conditionally by the State. The death-penalty inflicted upon criminals may be looked on in much the same light: it is in order that we may not fall victims to an assassin that we consent to die if we ourselves turn assassins. In this treaty, so far from disposing of our own lives, we think only of securing them, and it is not to be assumed that any of the parties then expects to get hanged. Again, every malefactor, by attacking social rights, becomes on forfeit a rebel and a traitor to his country; by violating its laws he ceases to be a member of it: he even makes war upon it. In such a case the preservation of the State is inconsistent with his own, and one or the other must perish; in putting the guilty to death, we slay not so much the citizen as an enemy. The trial and the judgment are the proofs that he has broken the social treaty, and is in consequence no longer a member of the State. Since, then, he has recognized himself to be such by living there, he must he removed by exile as a violator of the compact, or by death as a public enemy; for such an enemy is not a moral person, but merely a man; and in such a case the right of war is to kill the vanquished.... 31 Sample Questions

32 Critical Analysis and Reasoning Passage continued … …We may add that frequent punishments are always a sign of weakness or remission on the part of the government. There is not a single ill-doer who could not be turned to some good. The State has no right to put to death, even for the sake of making an example, any one whom it can leave alive without danger. The right of pardoning or exempting the guilty from a penalty imposed by the law and pronounced by the judge belongs only to the authority which is superior to both judge and law. i.e.. the Sovereign; even its right in this matter is far from clear, and the cases for exercising it are extremely rare. In a well-governed State there are few punishments, not because there are many pardons. but because criminals are rare: it is when a State is in decay that the multitude of crimes is a guarantee of impunity. Under the Roman Republic, neither the senate nor the consuls ever attempted to pardon; even the people never did so, though it sometimes revoked its own decision. Frequent pardons mean that crime will soon need them no longer, and no one can help seeing wither that leads. But I feel my heart protesting and restraining my pen; let us leave these questions to the just man who has never offended, and has never himself stood in need of pardon. Adapted from J.J. Rousseau, The Social Contract. ©1762 32 Sample Questions

33 Critical Analysis and Reasoning 28. In the fourth paragraph, Rousseau employs the metaphor of war to achieve which of the following? A. A comparison between putting a criminal offender to death and killing a vanquished enemy B. A contrast between a rebel and a traitor to one's country C. A contrast between the peaceful ideal of the State and the violent reality of the State D. A contrast between putting a criminal offender to death and killing a vanquished enemy NOTE: THIS IS A STRUCTURE QUESTION 33 Sample Questions

34 Critical Analysis and Reasoning 28. In the fourth paragraph, Rousseau employs the metaphor of war to achieve which of the following? A. A comparison between putting a criminal offender to death and killing a vanquished enemy B. A contrast between a rebel and a traitor to one's country C. A contrast between the peaceful ideal of the State and the violent reality of the State D. A contrast between putting a criminal offender to death and killing a vanquished enemy A. Yes. See fourth paragraph. B. No. The contrast is not between a rebel and a traitor, but between someone loyal and a rebel or traitor. C. No. Rousseau speaks of war in the fourth paragraph. D. No. See fourth paragraph. These two things are similar; no contrast is drawn. NOTE: THIS IS A STRUCTURE QUESTION 34 Sample Questions

35 Critical Analysis and Reasoning 29. As it is used in the passage, the term "Sovereign" refers to: A. the State. B. a superior judge. C. a higher being. D. a King. NOTE: THIS IS A VOCABULARY-IN-CONTEXT QUESTION 35 Sample Questions

36 Critical Analysis and Reasoning 29. As it is used in the passage, the term "Sovereign" refers to: A. the State. B. a superior judge. C. a higher being. D. a King. A. Yes. In the sixth paragraph, the State is personified; this paragraph shows that "the Sovereign" is a thing rather than a person by the use of the pronoun "its." B. No. See paragraph 6. The Sovereign is superior to the judge. C: No. There is no indication that the State is run by a deity. D: No. This is a trap based on the common use of the word; paragraph 6 clearly refers to “the Sovereign" as a nonhuman entity. NOTE: THIS IS A VOCABULARY-IN-CONTEXT QUESTION 36 Sample Questions

37 Critical Analysis and Reasoning 30. Based on information in the passage, which one of the following opinions could most reasonably be ascribed to the author? A. The rights of the individual are more important than the rights of the State. B. All malefactors have a right to rehabilitation at the State's expense. C. Rousseau does not feel he is qualified to judge the actions of others. D. Individual rights are always protected by the State. NOTE: THIS IS AN INFERENCE QUESTION 37 Sample Questions

38 Critical Analysis and Reasoning 30. Based on information in the passage, which one of the following opinions could most reasonably be ascribed to the author? A. The rights of the individual are more important than the rights of the State. B. All malefactors have a right to rehabilitation at the State's expense. C. Rousseau does not feel he is qualified to judge the actions of others. D. Individual rights are always protected by the State. C. A: No. This contradicts Rousseau's position. B: No. This extreme position is not supported by the passage. C: Yes. See seventh paragraph. D: No. See fourth paragraph. "Social rights" are protected, not all individual rights. NOTE: THIS IS AN INFERENCE QUESTION 38 Sample Questions

39 Biological and Biochemical Foundations of Living Systems 39 Sample Questions

40 Biological and Biochemical Foundations of Living Systems 40 Sample Questions

41 Biological and Biochemical Foundations of Living Systems 41 Sample Questions

42 Biological and Biochemical Foundations of Living Systems 42 Sample Questions

43 Biological and Biochemical Foundations of Living Systems 43 Sample Questions

44 Biological and Biochemical Foundations of Living Systems 6. Additional experiments were conducted on the genomic DNA isolated from Langerhans cells from the 10 vitiligo patients in the passage. Researchers found that each patient had the same genomic mutation. Given the results in Table 1 and Experiment 2, which of the following could be true of this mutation? I. The mutation is a nonsense mutation in the NALP1 gene. II. The mutation is in the promoter region of the NALP1 gene. Ill. The mutation resulting in the NALP1 phenotype could be in the gene for another protein. A. II only B. III only C. I and III D. II and III 44 Sample Questions

45 Biological and Biochemical Foundations of Living Systems 6. Additional experiments were conducted on the genomic DNA isolated from Langerhans cells from the 10 vitiligo patients in the passage. Researchers found that each patient had the same genomic mutation. Given the results in Table 1 and Experiment 2, which of the following could be true of this mutation? I. The mutation is a nonsense mutation in the NALP1 gene. II. The mutation is in the promoter region of the NALP1 gene. Ill. The mutation resulting in the NALP1 phenotype could be in the gene for another protein. A. II only B. III only C. I and III D. II and III D. According to the results in Table 1 and Experiment 2, the vitiligo patients have an NALP1 protein that is the normal length, but in increased amounts. Thus, the NALP1 mutation likely affects the regulation of NALP1 expression, rather than the structure of the NALP1 protein itself. Item I is false: a nonsense mutation introduces a premature stop codon and would result in a shortened NALP1 protein (choice C can be eliminated). Item II is true: a mutation in the promoter region for the NALP1 gene could result in e gene expression. For example, the mutant promoter could attract RNA polymerase II with greater ease, leading to increased NALP1 expression (choice B can be eliminated). Item III is true: other proteins, such as transcription factors or repressors, can affect gene expression. A mutation in a protein that regulates NALP1 transcription could result in overexpression of the NALP1 protein (choice A can be eliminated and choice D is correct). 45 Sample Questions

46 Biological and Biochemical Foundations of Living Systems NOTE: THIS IS A FREESTANDING QUESTION 48. Chloramphenicol is an antibiotic with an extremely lipid-soluble molecular structure. It binds to the large subunit of 70S ribosomes and prevents peptidyl transferase activity. Chloramphenicol is effective against almost all bacteria; however, it is considerably toxic to humans. This is most likely because chloramphenicol: A. is able to diffuse into the mitochondria and affect mitochondrial protein synthesis. B. is able to diffuse into the nucleus and block transcription of rRNA. C. affects both human and bacterial ribosomes. D. disrupts the cell membrane. 46 Sample Questions

47 Biological and Biochemical Foundations of Living Systems NOTE: THIS IS A FREESTANDING QUESTION 48. Chloramphenicol is an antibiotic with an extremely lipid-soluble molecular structure. It binds to the large subunit of 70S ribosomes and prevents peptidyl transferase activity. Chloramphenicol is effective against almost all bacteria; however, it is considerably toxic to humans. This is most likely because chloramphenicol: A. is able to diffuse into the mitochondria and affect mitochondrial protein synthesis. B. is able to diffuse into the nucleus and block transcription of rRNA. C. affects both human and bacterial ribosomes. D. disrupts the cell membrane. A. Mitochondria have DNA and transcribe and translate a few proteins independently. The mitochondrial system is almost identical to that of the prokaryotes (this is where the theory that mitochondria are ancient bacterial parasites that live symbiotically within eukaryotes comes from). Chloramphenicol is able to diffuse into mitochondria in concentrations high enough to disrupt mitochondrial protein synthesis, ultimately causing the death of the eukaryotic cell. Human (eukaryotic) ribosomes are 80S ribosomes, so they would not be affected by a drug that inhibits 70S ribosomes (C is wrong), and there is no information given to suggest that they disrupt cell membranes or block transcription (B and D are wrong). 47 Sample Questions

48 Biological and Biochemical Foundations of Living Systems NOTE: THIS IS A FREESTANDING QUESTION 15. Lysine exists as a zwitterion at pH 9.8. Which of the following moieties would most likely be found on its side chain at physiologic pH (approximately 7.4)? A. An unprotonated amino group B. A protonated amino group C. A sulfur group D. An ester group 48 Sample Questions

49 Biological and Biochemical Foundations of Living Systems NOTE: THIS IS A FREESTANDING QUESTION 15. Lysine exists as a zwitterion at pH 9.8. Which of the following moieties would most likely be found on its side chain at physiologic pH (approximately 7.4)? A. An unprotonated amino group B. A protonated amino group C. A sulfur group D. An ester group B. The side chain on lysine is -CH 2 CH 2 CH 2 CH 2 NH 2. Under acidic conditions, it would be protonated. 49 Sample Questions

50 Psychological, Social, and Biological Foundations of Behavior Guided meditation and deep-breathing exercises have long been used as effective techniques for stress reduction. The mechanism of action for this non-pharmacologic intervention is not entirely known but scientists believe that the act of focusing ones thoughts and deep belly-breathing both serve to somehow inhibit the stress response activated by the hypothalamic-pituitary-adrenal axis. Practitioners of meditation are capable of reducing their heart and respiration rates seemingly on command. Irritable Bowel Syndrome or IBS is a disorder that causes a range of abdominal discomfort and bowel irregularities, but unlike bowel diseases with similar symptoms, there are no physical abnormalities; rather, the disorder appears to be the physical manifestation of psychological triggers. For example, IBS is often comorbid with anxiety disorders or episodes of extreme stress. Acute anxiety and stress are known triggers for IBS symptoms, which usually include severe abdominal cramping, bloating, gassiness, constipation and/or diarrhea (sometimes sufferers experience one or the other more frequently, and a minority of sufferers experience both in an alternating pattern). IBS symptoms usually begin during late teen or early adult years, and a majority of sufferers are women. The current standard non-pharmacologic treatment for IBS is cognitive behavior therapy (CBT). CBT treats IBS sufferers by treating the emotional and psychological triggers that cause physical symptoms. A trained therapist uses a structured, goal- oriented plan to identify thought patterns and behaviors that trigger IBS symptoms, and provides patients with very specific tools for recognizing these, and implementing techniques to replace these negative thoughts and behaviors with more positive ones. In an attempt to determine if meditation is as beneficial as CBT for treating IBS, a recent six-month study was conducted on female IBS sufferers. Eligible participants had active IBS symptoms for at least three months during the past year. Participants with and without a diagnosed anxiety disorder were recruited to participate in this study. Subjects were randomly assigned to one of three groups: a CBT group, a guided-meditation group, and a no- treatment group. Approximately 65% of the participants had an anxiety disorder, and these subjects were roughly equally represented in each of the three groups. The results of this study, measured by percent reduction of IBS symptoms after treatment, are summarized in Figure 1. 50 Sample Questions

51 Psychological, Social, and Biological Foundations of Behavior 1. Based on the results of this study, what can be most reasonably concluded about the efficacy of CBT for IBS sufferers who do not have an anxiety disorder? A. CBT is more effective than no treatment and more effective than meditation. B. CBT and meditation combined provide the most effective treatment possible. C. CBT is not as effective as meditation. D. CBT is equally effective for IBS sufferers with and without anxiety disorders. 51 Sample Questions

52 Psychological, Social, and Biological Foundations of Behavior 1. Based on the results of this study, what can be most reasonably concluded about the efficacy of CBT for IBS sufferers who do not have an anxiety disorder? A. CBT is more effective than no treatment and more effective than meditation. B. CBT and meditation combined provide the most effective treatment possible. C. CBT is not as effective as meditation. D. CBT is equally effective for IBS sufferers with and without anxiety disorders. C. According to Figure 1, CBT, appears to be far less effective than meditation at reducing IBS symptoms for participants without an anxiety disorder (choice C is correct and choice A is wrong). It is also far less effective for participants without an anxiety disorder than it is for participants with an anxiety disorder (choice D is wrong). CBT and meditation were not tested in combination (choice B can be eliminated). 52 Sample Questions

53 Psychological, Social, and Biological Foundations of Behavior 3. The average individual diagnosed with IBS is a 40-50 year old female who is white, educated, married, and middle to upper-middle class. Based on this information, what might you conclude about IBS? A. IBS is underdiagnosed in less-affluent populations. B. IBS rarely affects younger men and women C. There is a causal relationship between education status and IBS. D. Age, gender, race, and marital status should all be viewed as risk factors for developing IBS. 53 Sample Questions

54 Psychological, Social, and Biological Foundations of Behavior 3. The average individual diagnosed with IBS is a 40-50 year old female who is white, educated, married, and middle to upper-middle class. Based on this information, what might you conclude about IBS? A. IBS is underdiagnosed in less-affluent populations. B. IBS rarely affects younger men and women C. There is a causal relationship between education status and IBS. D. Age, gender, race, and marital status should all be viewed as risk factors for developing IBS. A. Since the passage states at the end of the second paragraph that "IBS symptoms usually begin during late teen or early adult years" choice B is wrong, and we might conclude that these individuals are not being diagnosed because they are less-affluent, and have perhaps less access to medical care (choice A is correct). In fact, many psychiatric illness and disorders are underdiagnosed in less affluent populations. Based solely on the information provided, you cannot conclude that there is a causal relationship between the listed factors and IBS (choice C is wrong), nor can you assume that any of these factors increase one's risk for developing IBS (choice D is wrong). Correlation does not imply or prove causation. 54 Sample Questions

55 Psychological, Social, and Biological Foundations of Behavior 4. Given the description of the study in this passage, which unknown factor might have the most influence on the validity of the results? A. Sample size B. Duration of IBS symptoms before entering the study C. Participants' previous exposure to medication to treat IBS symptoms D. Length of the treatment protocols 55 Sample Questions

56 Psychological, Social, and Biological Foundations of Behavior 4. Given the description of the study in this passage, which unknown factor might have the most influence on the validity of the results? A. Sample size B. Duration of IBS symptoms before entering the study C. Participants' previous exposure to medication to treat IBS symptoms D. Length of the treatment protocols A. In statistics, validity refers to the whether results of a given study are able to answer the question being posed by that study. In the case of this study, the question is whether meditation is as effective as the current standard therapy (CBT), at reducing IBS symptoms for participants with and without an anxiety disorder. Based on the description provided in the passage, we do not know all of the specifics about this study, though we do know that the study duration is six months (choice D is wrong). While we do not know the overall duration of IBS symptoms for participants, we do know that participants must have had active IBS for at least three months in the past year (choice B is wrong). Prior exposure to medication to treat IBS symptoms is of unknown importance, but the sample size of this study is definitely not known, and the results cannot prove that meditation is as effective as CBT without an appropriately large sample size (choice A is better than choice C). 56 Sample Questions

57 Psychological, Social, and Biological Foundations of Behavior 7. How might Sigmund Freud have treated an IBS sufferer? A. By helping the patient discover the physical cause of their symptoms through various stress tests B. With a psychoanalytic approach that would attempt to pinpoint the root of the disorder in a sufferer's unconscious C. In a group therapy session with sufferers of other psychological disorders D. Dr. Freud would be unlikely to treat an IBS sufferer, because he would not consider their disorder to have a psychological cause 57 Sample Questions

58 Psychological, Social, and Biological Foundations of Behavior 7. How might Sigmund Freud have treated an IBS sufferer? A. By helping the patient discover the physical cause of their symptoms through various stress tests B. With a psychoanalytic approach that would attempt to pinpoint the root of the disorder in a sufferer's unconscious C. In a group therapy session with sufferers of other psychological disorders D. Dr. Freud would be unlikely to treat an IBS sufferer, because he would not consider their disorder to have a psychological cause B. Sigmund Freud founded psychoanalysis, a major premise of which is that the unconscious is responsible for most (if not all) psychological disorders; additionally the passage states that the disorder is a physical manifestation of psychological triggers (choice B is correct). Freud believed that just about every ailment had some root in the psyche (choice D is wrong), and used a variety of treatment techniques, including free-association and hypnosis; however, Freud is not known for utilizing group therapy (choice C is wrong) or stress tests (choice A is wrong). 58 Sample Questions

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