Questões de Concurso Público CESMAC 2017 para Prova de Medicina-2018.1-1° DIA- PROVA TIPO 1

Read the text below and answer the following question based on it.  

In a recent study, patients experienced reduced phantom limb pain after playing an augmented reality car racing game that required them to move the missing limb. Phantom limb pain is the experience of pain in a limb after it has been amputated. 
The underlying mechanisms responsible for phantom limb pain remain unclear. However, it appears that it may arise as a consequence of abnormal neural circuitry in central areas of the brain.
Limited success has been achieved with mirror therapy in which reflections of the unaffected limb can be used to create the illusion that the amputated limb is moving. 

The latest study has taken the mirror therapy concept a step further; patients visualise and 'move' the phantom limb using augmented reality—‘phantom motor execution’. It was conducted in 14 patients who had been experiencing phantom limb pain since the amputation of an arm. 
Sensors that could detect muscular activity were attached to the stump of the missing arm. The signals received by these sensors were then used to produce an image of an active arm on a computer screen. 
Patients were trained to use these signals to control the virtual arm, drive a virtual race car around a track and to copy the movements of an arm on screen with their phantom movements. After twelve 2-hour treatment sessions, the patients underwent follow-up interviews 1, 3 and 6 months later. 
Based on the patients' ratings, the intensity, quality, and frequency of pain had reduced by 50% after the treatment.
At the start of the study, 12 patients reported feeling constant pain whereas only 6 did 6months after the treatment. However, one patient thought that there was not a considerable difference in the levels of phantom pain before and after treatment.

Adaptado de: <https://www.news-medical.net/news/20161202/Virtual-reality-may-help-relieve-phantom-limb-pain.aspx?utm_source=TrendMD&utm_medium=cpc&utm_> (Acessado em 11 de outubro de 2017). 

Read the text below and answer the following question based on it. 

Two-year-old Jaga and Kalia underwent 16 hours of surgery, and are now in the intensive care unit, doctors said. 
A team of 30 doctors carried out the surgery - the first of its kind in India - at a state-run hospital. 
The boys were born with shared blood vessels and brain tissues, a very rare condition that occurs once in about three million births. 
The director of the All India Institute of Medical Sciences, Randeep Guleria, told the Press Trust of India that the "next 18 days would be extremely critical to ascertain the success of the surgery". 
The twins, hailing from a village in eastern Orissa state, were joined at the head - a condition known as craniopagus. 
Even before the operation they had defeated the odds; craniopagus occurs in one in three million births, and 50% of those affected die within 24 hours, doctors say. 
"Both the children have other health issues as well. While Jaga has heart issues, Kalia has kidney problems," neurosurgeon A K Mahapatra said. 
"Though initially Jaga was healthier, now his condition has deteriorated. Kalia is better," he added. 
Doctors said the most challenging job after the separation was to "provide a skin cover on both sides of the brain for the children as the surgery had left large holes on their heads". 
"If the twins make it, the next step will be reconstructing their skulls," plastic surgeon Maneesh Singhal said. 
The first surgery was performed on 28 August when the doctors created a bypass to separate the shared veins that return blood to the heart from the brain. 

Adaptado de: <http://www.bbc.com/news/world-asia-india-41772987>Acessado em 27 de outubro de 2017. 

Gene editing is the modification of DNA sequences in living cells. What that means in reality is that researchers can either add mutations or substitute genes in cells or organisms. 
Gene editing holds the key to preventing or treating debilitating genetic diseases, giving hope to millions of people around the world. Yet the same technology could unlock the path to designing our future children, enhancing their genome by selecting desirable traits such as height, eye color, and intelligence. 
While this concept is not new, a real breakthrough came 5 years ago when several scientists saw the potential of a system called CRISPR/Cas9 to edit the human genome.
CRISPR/Cas9 allows us to target specific locations in the genome with much more precision than previous techniques. This process allows a faulty gene to be replaced with a non-faulty copy, making this technology attractive to those looking to cure genetic diseases. 
The technology is not foolproof, however. Scientists have been modifying genes for decades, but there are always trade-offs. We have yet to develop a technique that works 100 percent and doesn't lead to unwanted and uncontrollable mutations in other locations in the genome.
In a laboratory experiment, these so-called off-target effects are not the end of the world. But when it comes to gene editing in humans, this is a major stumbling block.
The fact that gene editing is possible in human embryos has opened a Pandora's box of ethical issues.
Here, the ethical debate around gene editing really gets off the ground. 
When gene editing is used in embryos — or earlier, on the sperm or egg of carriers of genetic mutations — it is called germline gene editing. The big issue here is that it affects both the individual receiving the treatment and their future children. 
This is a potential game-changer as it implies that we may be able to change the genetic makeup of entire generations on a permanent basis.