Cone Cut in Radiograph

 # Which of the following describes the etiology of cone-cutting?
A. Inadequate exposure time
B. Excessive mA
C. Excessive kVp
D. Incorrect source-object distance
E. Incorrect placement of X-ray machine

The correct answer is E. Incorrect placement of X Ray machine.

Cone-cutting occurs when the X-ray machine is not lined up properly with the X-ray sensor or film.

The film or sensor should be placed perpendicular to the X-ray
collimator to ensure that all of the necessary information is picked

External devices are often used to ensure that the film/sensor are
perpendicular to the X-ray collimator.

SLOB technique

  # A periapical radiograph suggests an opaque mass Over the apex of the maxillary right 2nd molar. A second periapical radiograph is made with the X-ray head adjusted in a more mesial direction. The second periapical suggests that the object in question has moved distally compared to the 1st radiograph. Which of the following directions describes the location of the object?
A.In-between the roots
B. Buccal to the tooth
C. Lingual to the tooth
D. Not enough information is provided

The correct answer is B. Buccal to the tooth.

The SLOB (Same Lingual, Opposite Buccal) rule suggests that the
object is buccal to the tooth.

Because the object moved opposite to the positioning of the X-ray
device for the 2nd radiograph it demonstrates buccal positioning
If the object moved mesially with the head of the X-ray head being
moved mesially, it would have demonstrated lingual/palatal

Difficulty in pronouncing T

 # A person wearing complete denture has difficulty in pronouncing T. The reason may be:
A. Too thick palatal area
B. Incorrect position of upper incisor teeth
C. Too thick mandibular bone
D. Reduced salivary flow

The correct answer is B. Incorrect position of upper incisor teeth. 

- Sounds like t, d, n, etc. are alveolar sounds. These sounds are produced with tip of tongue touching anterior palate.

- If maxillary anterior teeth are placed too far anteriorly, 'd' will sound like 't'.

- If they are placed too palatally, 't' will sound like 'd'. 

Lentulo spiral uses

 # Lentulo spirals are used for:
A. Locating canal orifice
B. Pulp extirpation
C. Enlarging coronal third of the root canal
D. Application of root canal sealer

The correct answer is D. Application of root canal sealer. 

- Finger pluggers are used for vertical compaction of gutta percha. 
- Finger spreaders are used for  lateral compaction of gutta percha.
- Lentulo spiral is used to deliver sealer or triple antibiotic paste to the root canal.

BPKIHS Online OPD Registration


B.P. Koirala Institute of Health Sciences (BPKIHS) has initiated an innovative service of Online registration and ticketing for providing OPD services from 2077-06-26. For this, the patients have to get themselves registered from the Android App BPKIHS  

Patients have to:
- register their personal details
- select the desired department and register the ticket / pay the stipulated amount via Khalti or eSewa or IMEPay
- If registered before 8:00 AM, the patients will be registered for the same day, and those registering after 8:00 AM will be registered for the next day. Patients have to collect their OPD cards from the counter in the respective departments and enter the doctor's chamber. 

At present, this service is available only for routine OPD (daily regular OPD). In the upcoming days, Institutional based private practice (Private OPD) registration will also be incorporated in the app.

Staffs from respective departments working in the OPD should collect the OPD cards of the patients registered through online within 9:00 AM on the same day. 

Age related gingival recession

# Age-related gingival recession can be best treated by:
A. Gingivoplasty
B. Pedicle graft
C. Free gingival graft
D. No treatment

The correct answer is D. No treatment.

Gingival recession increases with age, the incidence varies from 8% in children to 100% after the age of 50 years. This has led to some investigators to assume that recession may be a physiologic process related to ageing. 

Tooth most affected by gingivitis

 # Facial surface of which tooth is most affected by gingivitis?
 A. Upper first molar
 B. Lower first molar
 C. Lower central incisor
 D. Lower premolar

The correct answer is A. Upper first molar.

Facial surface of upper first molar and lingual surface of lower central incisors is most affected by gingivitis. This is due to close proximity to opening of salivary ducts.

Life saver shaped gingival enlargement of Marginal Gingiva

 # Life saver shaped gingival enlargement of marginal gingiva is called:
 A. Stillman's cleft
 B. McCall's festoons
 C. Widow peaks
 D. Craters

The correct answer is B. McCall's festoons.

The term McCall's festoons has been used to describe a rolled, thickened band of gingiva that is usually seen adjacent to the cuspids when recession approaches the mucogingival junction.

Stillman clefts are apostrophe shaped indentations extending to marginal gingiva. They are usually present on facial surface. 

Craters are bony defects or concavities found in interdental areas.

Widow peaks are pseudo piling up of gingiva when failed to remove bony discrepancies at gingival line angles during osteotomy procedures. These are peaks of residual cortical bone left out during horizontal grooving at the facial/palatal/lingual line angles. 

Radiographic finding of Aggressive periodontitis

 # One of the radiographic finding of Aggressive periodontitis is arc shaped bone loss extending from:
A. Distal surface of the second premolar to mesial surface of second molar
B. Distal surface of the first premolar to mesial surface of first molar
C. Mesial surface of the second molar to distal surface of the first premolar
D. Mesial surface of the first premolar to distal surface of the second premolar

The correct answer is A. Distal surface of the second premolar to mesial surface of second molar

- Localized Juvenile Periodontitis is characterized by distribution of lesions in the first molars and incisors with least destruction in the cuspid-premolar area whereas in Generalized Juvenile periodontitis, there is generalized involvement of teeth.

- Vertical bone loss around incisors and molars in otherwise healthy teenagers is diagnostic of Localized juvenile periodontits.

- There is an arc shaped bone loss extending from distal surface of second premolar to mesial surface of second molar creating a mirror image type of bone loss which is characteristic of Juvenile periodontitis. 

Malignant involvement of lymph nodes

# Which  is  the  preferred  method  of  biopsy  in  case  of  a  malignant  involvement  of  lymph  node? 
a. Fine needle  aspiration 
b. Incisional  biopsy
c. Excisional biopsy 
d. No  biopsy

The correct answer is A. Fine needle aspiration.

Fine-needle aspiration (FNA) is a diagnostic procedure used to investigate lumps or masses. In this technique, a thin (23–25 gauge (0.52 to 0.64 mm outer diameter)), hollow needle is inserted into the mass for sampling of cells that, after being stained, are examined under a microscope (biopsy). The sampling and biopsy considered together are called fine-needle aspiration biopsy (FNAB) or fine-needle aspiration cytology (FNAC) (the latter to emphasize that any aspiration biopsy involves cytopathology, not histopathology). Fine-needle aspiration biopsies are very safe minor surgical procedures. Often, a major surgical (excisional or open) biopsy can be avoided by performing a needle aspiration biopsy instead, eliminating the need for hospitalization. In 1981, the first fine-needle aspiration biopsy in the United States was done at Maimonides Medical Center. Today, this procedure is widely used in the diagnosis of cancer and inflammatory conditions.

Aspiration is safer and far less traumatic than an open biopsy; complications beyond bruising and soreness are rare. However, the few problematic cells can be too few (inconclusive) or missed entirely (a false negative).

This type of sampling is performed for one of two reasons:
- A biopsy is performed on a lump or a tissue mass when its nature is in question.
- For known tumors, this biopsy is performed to assess the effect of treatment or to obtain tissue for special studies.

When the lump can be felt, the biopsy is usually performed by a cytopathologist or a surgeon. In this case, the procedure is usually short and simple. Otherwise, it may be performed by an interventional radiologist, a doctor with training in performing such biopsies under x-ray or ultrasound guidance. In this case, the procedure may require more extensive preparation and take more time to perform.

Also, fine-needle aspiration is the main method used for chorionic villus sampling, as well as for many types of body fluid sampling.

It is also used for ultrasound-guided aspiration of breast abscess, of breast cysts, and of seromas.

Pulp stem cells are:

 # The pulp stem cells are:
A. Pluripotent in nature
B. Totipotent in nature
C. Multipotent in nature
D. None of the above

The correct answer is A. Pluripotent in nature.

Pulpal stem cells are pluripotent in nature.
The stem cells were shown to undergo proliferation and migrate to the site of injured odontoblasts and produce dentin.