Oh GOODY, exam time again.

Joy to the world. Doom and gloom upon my face.
Third year exams are in the format of 4 essay questions, of which you have to pick two. I did four modules this semester, so I have five exams. The fifth exam is a 2 hour synoptic essay.
To gain good marks, you’re expected to show evidence of extra reading – for example in the form of a critical analysis of techniques or the use of specific examples.

My modules this semester are:
– Macromolecular machines – experimental methods to find out how these work. E.g ribosomes.
– Protein assembly – how proteins fold up, virus assembly and such gubbins. Epically interesting.
– Immunology
– Human disease

The exam I had today, my first one, was all about human disease, specifically when inflammation goes haywire, as well as autoimmune disease. I only really chose this module for interest. My main focus is biophysics – protein folding and such gubbins, but I thought I’d better chose some “lighter” modules to stop myself getting bogged down in all the maths. Besides, my main drive in life is to find out how and why everything works – including why the body goes “wrong” sometimes.

Scanning down the list of questions, deciding which essay to attack first, almost caused me to jump up and do a little dance on my table. “Compare and contrast the cells and molecules involved in atherosclerosis and asthma” was exactly the question I wanted to answer. I had done insane buckets of extra reading on these topics, so i could insert all sorts of smug references to literature. At once point I even had a crisis of nausea when I realised how exceedingly pompous my tone sounded. As I completed my answer with a flourish I knew that, unless I had made some horrendous glaring error, that essay would grab me a good mark.

The second essay was another barrel of eels entirely. I had to pick one question from the remaining three, all of which resembled soup of doom, or some odd alien substance you might find on the bottom of your shoe after a long drunken night out.

Question one was all about apoptosis – fair enough if it wasn’t necessary for me to remember the names of the infinite number of molecules involved and how they all hook up to form a tangled spaghetti network. Apoptosis presumably works by confusing the cell to death.

Candidate two was the process of diabetic kidney nephropathy. This made me irrationally angry and I nearly tore the paper up in rage. If they had asked me to describe mechanisms by which the kidney fails and the stages of this process – well that would be the essay of my dreams. I could have drawn examples from the many mechanisms that may cause kidneys to fail, including diabetes. The problem was this question was just about diabetes and I simply could not remember enough specifics about it to be able to do an entire essay on it. The question left no scope for interpretation or diversity. Frankly, question number two was irresponsible and unimaginative and pure laziness on the part of the dude who comes up with the questions.

So that just left question three. This one was all about immune tolerance – how the immune system goes about attacking foreign gubbins, but does not attack your own cells. The question was in two parts, firstly I had to write about how the immune system “creates” tolerance and how these mechanisms can go wrong. I couldn’t remember being taught much about that in this module. Fortunately, my immunology module came in handy, I just wrote everything I could remember from that. After burbling for a bit, I was faced with a predicament – this was meant to be half the essay and yet I had only been writing for ten minutes. Then TV saved the day. I KNEW watching episodes of House in between revision sessions was a brilliant idea – I was able to smatter “for example” all over my essay giving the impression I had done copious amounts of extra reading. I happily scrawled “paraneoplastic syndrome” in cancer as an example of how the immune system can accidentally attack itself. “LUPUS!” I joyfully thought with glee – in House it’s never lupus, but oh yes in this case it was definitely lupus.

Things started to go spazzmoid with the second part of the question. It commanded me to “pick one example of an organ-specific autoimmune disease, and describe its clinical characteristics”. My mind went blank and instead got fixated on semantics. I just could not think of an example that involved the mechanisms I had described above that was also organ-specific. “Rheumatoid arthritis,” I thought, “are joints on organ?” The odd thing was that this second part of the question didn’t seem very clear – did I have to relate it to the mechanisms of a breakdown in tolerance? In the end I figured anything autoimmune must be related to tolerance going silly bananas so I just picked autoimmune thyroid disease. My answer was along the lines of “errr, so an agonist binds the TSH receptor, meaning the thyroid is always switched on, errr. Yah.”

Then I mumbled something about weight loss, lethargy and goitre and got the hell out of the exam hall.