Exam scores up!

Scores for our final exam are now posted on Canvas! The mean was 92% – nice job, everyone! You should be able to see your exam in your Examplify dashboard (whatever that is) – if you can’t, let me know. You may want to check and see which questions you got wrong – and if you don’t understand something, just email me and we’ll go over it.

You can also now see all of your quiz scores, your 10 extra credit points (for giving the 10% Happier Meditation app a try at some point!), and your final point total for the course. If you have any questions, or if something seems amiss, let me know.

I hope you all have a wonderful break – you deserve it. What a year! Get lots of rest, have fun, and I’ll see you back IN THE CLASSROOM in September!

Something to make you happier!

In our exam review session, I mentioned that I had spoken with the people at Ten Percent Happier, and was able to get you guys a free 6-month subscription to their app, which is AMAZING. I want to help you guys as much as possible to deal with the stress of dental school in healthy ways – and I think these guys teach meditation in a very accessible, easy, do-able way.

I was hoping to get this to you last week, but then I got sick, and wasn’t even up to sitting at the computer – so unfortunately it’s coming at a very late date here. But maybe it’s good in a way, as you’ll have some extra time coming up to play with it a bit and see how you might integrate it into your day ūüôā

I think that a meditation practice, no matter how brief or small (even 1 minute a day) can be so potentially life-changing that I’m giving everyone 10 points extra credit for giving it a shot. I trust you, so no need to email me or anything.

You can do this at any time – I know you’re super busy studying for finals so if you want to wait until that’s over that’s fine!

Here’s what to do to get started.

1. Redeem your free 6-month subscription to the Ten Percent Happier app

  • Open UMNDENTISTRY to get to the gift redemption page on the TPH website.
  • If you’re a new user, register an account.
  • If you have an account, tap Sign In at the bottom of the screen
  • Tap Redeem on the next page.
  • Download the app from the Apple App Store or Google Play Store and sign in the same way you did to redeem your code.

2. Watch this short video in which Dan Harris talks about why meditation is useful.

3. Go through the Basics I course.

People who complete this course at the beginning of their experience are 10 times more likely to continue on to develop a practice! The course is very short (just a few minutes a day for 7 days) – so it’s doable. You can find it under the “Courses” tab on the app.

4. Let me know if you have any questions!

If you’re wondering why I think this is important, or if you’re having any issues with the app, or anything else – just drop me a quick email!

Final Exam Details (and a BIG thank you)

Hi everyone. Thanks so much for your patience with me this past week – so many of you wrote such kind emails I just sat here and cried a little reading each one of them. Thank you for your genuine compassion and caring! I’m so glad I get to have you guys for another course after this one – and in the actual classroom too!

Here are the details on our final exam.

Date/time. The exam will be open from 12:01 am until 11:59 pm on Wednesday, June 30, and you’ll have 2 hours to complete it once you start. Just be sure to get it uploaded by 11:59 pm tomorrow night. You can download the exam tonight starting at 7 pm (I wanted to give you some extra time to get it downloaded in case there were any issues).

Password. The assessment password is Almostsummer1.

Points/questions. The exam is worth a total of 48 points (I had estimated more like 60 points, but it wound up to be shorter).

Please note that Examplify makes it look like the exam only has 30 questions! The reason for this is because there are several matching questions on the exam – and instead of counting each item as a separate question, Examplify just assigns one question number to each group of items.

Here’s an a set of matching questions similar to those on the actual exam, so you can see what I mean:

Examplify would count this set of items as a single question, instead of four questions. Each of the items is worth one point, so it’s not a big deal in the end. It’s just kind of annoying that the number of questions shows up as 30 – and I wanted to explain why.

Exam breakdown. The exam point breakdown is as follows:

  • Cell injury (10 points)
  • Inflammation (6 points)
  • Wound healing (3 points)
  • Immunology (4 points)
  • Hypersensitivity reactions (2 points)
  • Autoimmune diseases (6 points)
  • Neoplasia 1 (2 points)
  • Neoplasia 2 (6 points)
  • Neoplasia 3 (2 points)
  • Neoplasia 4 (7 points)

That’s all I can think of! Please let me know if you have any questions, either about the material or about the exam itself.

Questions about neoplasia

neoplasia drawing square

Here are some really good questions about neoplasia. These are all questions from dental students in previous years’ classes – but maybe some of them will resonate with you.

Q. I don’t understand what is a non-neoplastic epithelial cell and what specifically is a neoplastic cell.

A. A non-neoplastic epithelial cell is just a regular old epithelial cell, sitting there in the skin or in a gland, doing its job and dying off when it’s supposed to.

A neoplastic epithelial cell is part of a tumor, and although it may look somewhat like a regular epithelial cell, it is able to divide and multiply on its own, regardless of external signals. We’ll talk about some other features of neoplastic cells on Wednesday – there are several! – but it’s the ability to grow on their own that really defines tumor cells. They just keep dividing, despite not being told to do so by the body. Pretty soon, there are so many that they actually make a visible or palpable mass. And if you don’t do anything, the mass will get bigger and bigger.

Q. By the definition of neoplasia (new excessive growth) I don’t understand how a non-neoplastic cell can develop into a tumor. If it is non-neoplastic how can there be no new accelerated cell growth and still develop a tumor?

A. In order to become neoplastic, regular old non-neoplastic cells have to undergo a bunch of genetic changes. You’re right: when they are not neoplastic, they don’t have this property of accelerated cell growth. They’re just regular cells that do their job and die off when it’s time.

But if a normal cell acquires certain genetic abnormalities – like the ability to go through the cell cycle without paying attention to checkpoints, or the ability to turn off the normal mechanisms that keep growth under control, or the ability to activate growth receptors when there’s not even any growth hormone attached – then that cell may end up becoming neoplastic.

Sometimes cells that acquire these abnormalities end up getting killed off by normal means (we have proteins that see when our DNA is mutated, and either fix it, or kill off the cell). But if these protective mechanisms don’t work (if a cell acquires a mutation in one of them), then the cell will live on despite all these mutated genes…and it will divide into two cells, and then into 4, and so on.

Usually there are many, many mutations that a cell has to undergo before it officially becomes neoplastic. And every tumor can have its own specific mutations – they’re not the same in every tumor.

Also: sometimes, as the cell acquires these mutations on the way to becoming a tumor cell (a neoplastic cell), it actually looks¬†different too! This seems to be especially true for epithelial cells. As an epithelial cell starts acquiring mutations and goes down the road that leads to neoplasia, it starts showing signs of dysplasia – it grows to an unusually large size, or the chromatin gets darker, or nucleoli show up, or it starts not respecting its neighbors’ space.

These morphologic changes are pretty predictable: cells become mildly dysplastic, then moderately dysplastic, then severely dysplastic. The more dysplastic they become, the more likely it is that they will continue on down the path to carcinoma in situ (and, evenutally, invasive carcinoma).

This morphologic progression doesn’t seem to happen the same way in non-epithelial cells. Non-epithelial cells (like muscle cells, or fat cells) may undergo some visible changes as they move towards neoplasia – but those changes are not as predictable or universal as the dysplastic changes that occur in epithelial cells.

Q. And why is it restricted to only epithelial cells?

A. If by “it” you mean neoplasia: neoplasia is not restricted to epithelial cells. Any cell in the body – epithelial, muscle, bone, cartilage, blood, fat, whatever – can become neoplastic.

The restriction we talked about in class was related to the dysplasia (as mentioned above). I don’t know why the same dysplastic changes don’t seem to occur in non-epithelial cells – but they don’t.

Q. How can non-neoplastic tumors become invasive without accelerated cell growth?

A. Tumors are neoplastic, by definition (tumor is just another word for neoplasia). So all tumors have this propensity to grow autonomously; some are benign (these are not typically invasive), and some are malignant (these typically are invasive).

Q. Also, are all malignant tumors anaplastic?

A. No – malignant tumors can show any level of differentiation they want. They can be well-differentiated (in which they look almost exactly like their cell of origin), moderately-differentiated (in which they sort of look like their cell of origin), poorly-differentiated (in which they really don’t look much like their cell of origin at all), or anaplastic (in which they look absolutely nothing like their cell of origin – they’re just super pleomorphic, with big ugly nuclei, no architecture, and lots of abnormal mitoses).

That being said: malignant tumors are more likely to be anaplastic than benign tumors. Benign tumors are usually well-differentiated (they are rarely, if ever, anaplastic), whereas malignant tumors can be anywhere on the differentiation spectrum.

Fletch

In our Neoplasia I: Nomenclature lecture, I talked about the movie Fletch as it related to tumor nomenclature. Fletch isn’t on Netflix, unfortunately – but it is on Amazon Prime, and if you’re on the fence between renting ($2.99) and buying ($7.99), my advice is to just buy it. It is so worth it.

I couldn’t find the exact scene I wanted to show you guys (the one where Fletch says “He has melanoma…carcinoma…some kind of noma“), probably because it wasn’t nearly as funny as the rest of the film. But I did find a couple good clips, in case you need a laugh. Here they are.

Clip 1: Dr. Rosenpenis

This is just silly, stupid humor, but actually, that’s exactly why I like it.

Clip 2: Autopsy assistant

This is great because it’s exactly how I felt at my first autopsy. I could tolerate the sight of the body, and even the sound (barely) of the bone saw – but the smell…oh man, the pathologist in this scene is spot-on: you just never get used to the smell.

A few updates

Hi everyone – I hope you’re all doing well! Just wanted to give you a few updates:

  1. The scores for quizzes 1 and 2 have now been entered in Canvas. As I mentioned in my email last week, I gave everyone the full 15 points for quiz 2 to make up (in part) for my missing class. Please check your scores for both quizzes and let me know if something doesn’t look right to you!
  2. The Kahoots for quizzes 1 and 2 are now posted on our Kahoots page, in case you want to review them.
  3. The Zoom recording for quiz 1 is now posted on our Lectures page, in case you want to review it.
  4. I have a gift for you guys, as I mentioned in my email last week. I’m going to tell you the details about it in class on Wednesday, June 23 (9:05-11:00). We’ll be reviewing for the final exam during that class period, but we won’t need the whole 2 hours – so I’ll take a few minutes at the beginning to tell you what it is and how to use it. I’m super excited!

As always, if you have any questions about this stuff, or about the neoplasia lectures, or about anything at all, don’t hesitate to send me an email. I’m happy to set up a Zoom session if that would work better than email too.

Quiz 2 moved to Wednesday

I apologize for the late notice – but I have a conflict and I need to move tomorrow’s Quiz to Wednesday (same time: 9:05 – 9:55).

The quiz will still just cover the lectures on May 31 and June 2. Our Lectures page has been updated to reflect this change. Please let me know if you have any questions – and again, I apologize for the late switch in plans.

Excuse me, may I smell your MHCs?

smell

Check out this interesting concept. You already know that the MHC I receptor is present on (pretty much) every cell in the body and presents antigen to cytotoxic T cells, and that the MHC II receptor is present only on specialized antigen-presenting cells and presents antigen to helper T cells. Right.

But did you know that these same receptors may be helping a woman decide on a mate? It seems that women prefer mates with MHCs very different from their own. That seems like a good idea – it helps provide diversity within the genome.

It would be hard to get a sample from every guy and bring it to the HLA-typing lab, but no need: the brain can detect MHC differences by smell (they’re associated with pheromones)! Weird. And cool.

Selena Gomez and others talk about lupus

Selena Gomez has been battling lupus for several years. She’s been open about her diagnosis (check out this ABC article¬†in which Selena and other patients talk about what it is really like to have lupus).

Several years ago, she underwent a kidney transplant for complications related to her disease. Her disease course is more severe than it is for many patients with the disease; kidney transplants are typically used only after other, less dangerous treatments fail.

Quiz 1 time change! and other info

Next week we have our first quiz on Wednesday, May 26. It was scheduled to begin at 9:05, but it appears that your Perio exam that morning may last until 9:30 or so. So I’m changing our quiz start time to 10:10 to give you guys a little time to finish Perio, take a deep breath, get a coffee, scream, whatever.

You can see the new start time for the quiz on our Lectures page. Fortunately we had two lecture slots that day, which made it easy to swap them around. So now we’ll have optional office hours in the first slot (from 9:05 – 9:55), and we’ll have our quiz in the second slot (from 10:10 – 11:00).

The quizzes in this course will each be worth 15 points towards your total score. We’ll use Kahoot as our quiz platform, and we’ll do the quizzes live over Zoom. If you want more information about how grades are calculated, you can find that on our About page, which also has a link to our syllabus.

You can check out some practice Kahoots on our Kahoots page if you want to brush up on how Kahoot works. Also, these quizzes are open-book (so feel free to use your lecture notes/ppts during the quiz), and you can talk with each other about your thought process with each question, or about why you feel a particular answer is right/wrong. Normally, we’d be doing these in the classroom, and that works really well for discussing things with the people around you. Now we’re virtual – but you can still chat with each other even if you’re not in the same room!

Let me know if you have any other questions about Wednesday’s quiz. Or about anything else, for that matter.