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AIIMS NOV 2012 MDS Past Entrance Exam MCQs - Dental MCQs


# Paralysis of cranial root of accessory nerve affects all except:
A. Cricopharyngeus
B. Salpingopharyngeus
C. Palatopharyngeus
D. Stylopharyngeus

# Direct and consensual light reflex is lost in which nerve palsy:
A. Trigeminal
B. Oculomotor
C. Optic
D. Trochlear

True regarding blood pressure is:

 # True regarding blood pressure is:
A. Diastolic BP is a more potent cardiovascular risk factor than is systolic BP until age 50
B. Systolic BP is a more potent cardiovascular risk factor   than is systolic BP until age 50
C.  Isolated Systolic hypertension most commonly is seen before age 50
D. Diastolic BP continues to rise throughout life



The correct answer is A. Diastolic BP is a more potent cardiovascular risk factor than is systolic BP until age 50.

The prevalence increases with aging, such that more than 65% of Americans aged 60 years and older have hypertension. If people live long enough, more than 90% will develop hypertension. Of note, systolic BP continues to rise throughout life, but diastolic BP rises until around age 50 years and then levels off or falls; as a result, after the age of 50, isolated systolic hypertension becomes the more prevalent pattern. In one study, isolated systolic hypertension was identified in 87% of inadequately controlled patients older than 60 years of age. Isolated diastolic hypertension most commonly is seen before age 50 years. Diastolic BP is a more potent cardiovascular risk factor than is systolic BP until age 50; thereafter, systolic BP is more important.

Reference: Little and Falace's Dental Management of the Medically Compromised Patient, 9th Edition, Page no. 39


Asymptomatic irritational fibroma should be treated by:

 # Asymptomatic irritational fibroma should be treated by:
A. Simple excision
B. Block resection
C. Radiation therapy
D. No treatment indicated



The correct answer is A. Simple excision.

The treatment for the fibroma, or focal inflammatory hyperplasia as the case may be, is conservative surgical excision. Seldom does the lesion recurs.

Reference: Shafer’s Textbook of ORAL PATHOLOGY, 7th Edition, Page No: 132


Surface of an oral squamous cell carcinoma

 # The surface of an oral squamous cell carcinoma will usually feel to the touch:
A. Smooth
B. Fluctuant
C. Slimy
D. Rough


The correct answer is D. Rough.

Clinically, almost all oral cancers, except those in the earliest stages have two very characteristic features in the form of ulceration and an indurated margin. In different sites; however, there are certain variations.

Reference: Shafer’s Textbook of ORAL PATHOLOGY, 7th Edition, Page No:  108

A smooth red tongue may be seen in all of the following except:

 # A smooth red tongue may be seen in all of the following except:
A. Vitamin K deficiency
B. Folic acid deficiency
C. Iron deficiency anemia
D. Vitamin  B12 deficiency



The correct answer is A. Vitamin K deficiency.

While an iron-deficiency anemia may occur at any age, the Plummer-Vinson syndrome occurs chiefly in women in the fourth and fifth decades of life. Presenting symptoms of the anemia and the syndrome are cracks or fissures at the corners of the mouth (angular cheilitis), a lemon-tinted pallor of the skin, a smooth, red, painful tongue (glossitis) with atrophy of the filiform and later the fungiform papillae, and dysphagia limited to solid food resulting from an esophageal stricture or web. These oral findings are reminiscent of those seen in pernicious anemia.

Reference: Shafer’s Textbook of ORAL PATHOLOGY, 7th Edition, Page No: 772

The word dilaceration means:

 # We understand one of the following by the word dilaceration?
Calcified root canals
Curvature of the root tip
Dysplasia of dentin
Cemental union of root



The correct answer is B. Curvature of the root tip.

The term ‘dilaceration’ refers to an angulation, or a sharp bend or curve, in the root or crown of a formed tooth. The condition is thought to be due to trauma during the period in which the tooth is forming, with the result that the position of the calcified portion of the tooth is changed and the remainder of the tooth is formed at an angle. The curve or bend may occur anywhere along the length of the tooth, sometimes at the cervical portion, at other times midway along the root or even just at the apex of the root, depending upon the amount of root formed when the injury occurred.

Reference: Shafer’s Textbook of ORAL PATHOLOGY, 7th Edition, Page No: 41

Macroglossia may be seen in:

 # Macroglossia may be seen in:
A. Prader willi syndrome
B. Down syndrome
C. Beckwith Weidemann syndrome
D. Grebe syndrome



The correct answer is C. Beckwith Weidemann syndrome.

Although the exact incidence of macroglossia is unknown (because the etiologies are too numerous to quantify), some congenital syndromes often express macroglossia in their phenotypes, most commonly Down syndrome (1 per 700 live births) and Beckwith-Wiedemann syndrome (0.07 per 1,000 live births). In Beckwith-Wiedemann syndrome, 97.5% of patients have macroglossia.

Reference: Shafer’s Textbook of ORAL PATHOLOGY, 7th Edition, Page No: 27

Cytologic smears and the findings of characteristic multinucleated giant cells (Tzanck test) are helpful in the diagnosis of:

 # Cytologic smears and the findings of characteristic multinucleated giant cells (Tzanck test) are helpful in the diagnosis of:
A. Chicken pox
B. Mumps
C. Psoriasis
D. Herpes Zoster



The correct answer is D. Herpes Zoster.

Herpes zoster can frequently be recognized by the characteristic distribution of the lesions, although there may be a similarity to the lesions of herpes simplex infection. Skin lesions and oral lesions in particular may be easily identified as viral diseases by cytologic smears and the finding of characteristic multinucleated giant cells (Tzanck test) and intranuclear inclusions. However, this does not differentiate between herpes zoster and herpes simplex. This can only be done by fluorescent antibody staining techniques, viral culture or serologic diagnosis.

Reference: Shafer’s Textbook of ORAL PATHOLOGY, 7th Edition, Page No: 351

Which of the following compulsorily involves two teeth?

 # Which of the following compulsorily involves two teeth?
A. Dilaceration
B. Gemination
C. Taurodontism
D. Concrescence



The correct answer is D. Concrescence.

Concrescence of teeth is actually a form of fusion which occurs after root formation has been completed. In this condition, teeth are united by cementum only. It is thought to arise as a result of traumatic injury or crowding of teeth with resorption of the interdental bone so that the two roots are in approximate contact and become fused by the deposition of cementum between them. Concrescence may occur before or after the teeth have erupted, and although it usually involves only two teeth, there is at least one case on record of union of three teeth by cementum.

Reference: Shafer’s Textbook of ORAL PATHOLOGY, 7th Edition, Page No: 41

The most frequent sequelae of gingivitis is:

 # The most frequent sequelae of gingivitis is:
A. Gingivosis
B. Periodontosis
C. Periodontitis
D. Gingival atrophy



The correct answer is C. Periodontitis.

Studies of gingivitis support the conclusion that disease development is associated with selected alterations in the microbial composition of dental plaque and not just the result of an accumulation of plaque. Gingivitis was generally thought to precede the development of chronic periodontitis; however, many individuals demonstrate long-standing gingivitis that never advances to the destruction of the periodontal attachment.

Reference: Carranza's Clinical Periodontology, 12th Edition, Page no: 163

What is usually done with an ‘eruptive cyst’ in the area of the second molar in a two year old child?

 # What is usually done with an ‘eruptive cyst’ in the area of the second molar in a two year old child?
A. Observe
B. Incise and drain
C. Excise
D. Fenestrate



The correct answer is A. Observe.

No treatment is necessary as the eruption cyst often ruptures spontaneously. Surgically exposing the crown of the tooth may aid the eruption process.

Reference: Shafer’s Textbook of ORAL PATHOLOGY, 7th Edition, Page No: 263

Median rhomboid glossitis is due to:

 # Median rhomboid glossitis is due to:
A. Persistence of tuberculum impar
B. Inflammation of the tongue
C. Hypertrophy of filiform papilla
D. Atrophy of circumvallate Papillae



The correct answer is A. Persistence of tuberculum impar.

Embryologically the tongue is formed by two lateral processes (lingual tubercles) meeting in the midline and fusing above a central structure from the first and second branchial arches, the tuberculum impar. The posterior dorsal point of fusion is occasionally defective, leaving a rhomboid-shaped, smooth erythematous mucosa lacking in papillae or taste buds. This median rhomboid glossitis (central papillary atrophy, posterior lingual papillary atrophy) is a focal area of susceptibility to recurring or chronic atrophic candidiasis, prompting a recent shift towards the use of posterior midline atrophic candidiasis as a more appropriate diagnostic term.

Reference: Shafer’s Textbook of ORAL PATHOLOGY, 7th Edition, Page No: 30

Ground glass appearance of bone is seen in:

 # Ground glass appearance of bone is seen in:
A. Osteoporosis
B. Achondroplasia
C. Fibrous dysplasia
D. Fluorosis



The correct answer is C. Fibrous dysplasia.

In fibrous dysplasia, the medullary bone is replaced by fibrous tissue, which appears radiolucent on radiographs, with the classically described ground-glass appearance. Trabeculae of woven bone contain fluid-filled cysts that are embedded largely in collagenous fibrous matrix, contributes to the generalized hazy appearance of the bone.

Reference: Shafer’s Textbook of ORAL PATHOLOGY, 7th Edition, Page No: 710

Ludwig’s Angina involves:

 # Ludwig’s Angina involves:
A. Submaxillary space
B. Submental space
C. Sublingual space
D. All of the above


The correct answer is D. All of the above.

When the perimandibular spaces (submandibular, sublingual, and submental) are bilaterally involved in an infection, it is known as Ludwig’s angina. This infection is a rapidly spreading cellulitis that can obstruct the airway and commonly spreads posteriorly to the deep fascial spaces of the neck.

Reference: Contemporary Oral and Maxillofacial Surgery, James R. Hupp, 6th Edition 2013, Page No 326

Submaxillary space is another name for submandibular space.

The most common malignant lesion of bone:

 # The most common malignant lesion of bone:
A. Osteosarcoma
B. Metastatic carcinoma
C. Osteochondroma
D. None of the above



The correct answer is A. Osteosarcoma.

 The most common primary malignant bone tumors are osteosarcoma (35%), chondrosarcoma (25%), and Ewing's sarcoma (16%). Less frequently (≤ 5%) occurring tumors are chordoma, malignant fibrous histiocytoma of bone, and fibrosarcoma of bone.



While palpating lymph nodes in the neck, the least important is its:

 # While palpating lymph nodes in the neck, the least important is its:
A. Size
B. Mobility
C. Consistency
D. Pain


The correct answer is B. Mobility.

Alcohol as a risk factor for cancer - Does alcohol cause cancer?

Alcohol consumption is the most important risk factor for development of oral cancer in non-smokers. It is also considered as the second independent major risk factor for the development of oral cancer. It is estimated that an average consumption of over 30 ml of alcohol per day increases the risk of oral cancer linearly with the quantity of alcohol consumed. Though any form of alcohol when consumed in large
quantities is dangerous, it is believed that dark colored drinks are more hazardous (as they may contain higher beverage congeners such as nitrosamines, hydrocarbons and other impurities which are known carcinogens). Carcinogens present in the tar are insoluble in saliva but are highly soluble in alcohol and easily absorbed in the oropharynx.




The International Agency for Research on Cancer published a monograph in 1982, which details the various methods in which alcohol predisposes to head and neck cancers.
❍ Ethyl alcohol increases the permeability of oral mucosa. It also dehydrates the mucosa. It has a solvent action on the keratinocyte membrane thereby allowing the passage of carcinogens into proliferating cells where they may exert a mutagenic action.

❍ The immediate metabolite of ethanol is acetaldehyde, which readily damages cells. It is believed that those who are rapid acetylators are at increased risk of developing cancers.

❍ Alcoholic liver disease is common in heavy drinkers and this minimizes the detoxification of carcinogens.

❍ Alcohol, owing to its high calorific value, suppresses appetite in heavy drinkers. This predisposes to nutritional deficiency which in turn is a risk factor for cancers. Compared to non-users, alcohol users are 3.6 times more likely to have oropharyngeal cancer, 5.8 times for tobacco users, and 19 times for users of both alcohol and tobacco.

Reference: Textbook of Oral Medicine, Oral Diagnosis and Oral Radiology Second Edition, Ravikiran Ongole, Page no: 384

Kaposi’s sarcoma is a tumor of:

 # Kaposi’s sarcoma is a tumor of:
A. Smooth muscle
B. Striated muscle
C. Blood vessels
D. Reticuloendothelial system



The correct answer is C. Blood vessels.

Kaposi’s sarcoma is a low-grade and relatively indolent malignant multifocal tumour of lymphatics or blood vessels caused by infection with human herpesvirus 8 (HHV-8). Its status as a true malignant neoplasm is unclear as it shows a range of behaviours. Most patients are immunosuppressed. Therapeutic immunosuppression with ciclosporin and tacrolimus can be associated with Kaposi’s sarcoma, but by far the main predisposing condition is HIV infection, and almost all oral Kaposi’s sarcoma is in HIV-infected patients. Among HIVinfected patients, Kaposi’s sarcoma affects mainly men who have sex with men. Antiretroviral therapy for HIV has greatly reduced the incidence of Kaposi’s sarcoma, but it remains the most common type of intraoral sarcoma.

Ref: Cawson’s Essentials of Oral Pathology and Oral Medicine, 9th Edition Page no 380

Chemotherapeutic agent has following side effects EXCEPT:

 # Chemotherapeutic agent has following side effects EXCEPT:
A. Hair loss
B. Diarrhoea
C. Hypertension
D. Mucositis


The correct answer is C. Hypertension.

Majority of the cytotoxic drugs have more profound effect on rapidly multiplying cells, because the most important target of action are the nucleic acids and their precursors, and rapid nucleic acid synthesis occurs during cell division. Many cancers (especially large solid tumours) have a lower growth fraction (lower percentage of cells are in division) than normal bone marrow, epithelial linings, reticuloendothelial (RE) system and gonads. These tissues are particularly affected in a dose-dependent manner by majority of drugs; though, there are differences in susceptibility to individual members.

KD Tripathi Page 859, 7th Edition


Most common oral change of nutritional anemia is:

# Most common oral change of nutritional anemia is:
A. Atrophic glossitis
B. Leukoplakia
C. Lichen planus
D. Hypertrophic glossitis



The correct answer is A. Atrophic glossitis.

Glossitis is one of the more common symptoms of pernicious anemia. The patients complain of
painful and burning lingual sensations which may be so annoying that the dentist is often consulted first for local relief. The tongue is generally inflamed, often described as ‘beefy red’ in color, either in entirety or in patches scattered over the dorsum and lateral borders. In some cases, small and shallow ulcers — resembling aphthous ulcers — occur on the tongue. Characteristically, with the glossitis, glossodynia and glossopyrosis, there is gradual atrophy of the papillae of the tongue that eventuate in a smooth or ‘bald’ tongue which is often referred to as Hunter’s glossitis or Moeller’s glossitis and is similar to the ‘bald tongue of Sandwith’ seen in pellagra. Loss or distortion of taste is sometimes reported accompanying these changes. The fiery red appearance of the tongue may undergo periods of remission, but recurrent attacks are common.

Shafer 7th Edition, Page no: 763


Cyanosis of lips is a common finding in all EXCEPT:

# Cyanosis of lips is a common finding in all EXCEPT:
A. Polycythemia
B. Sickle cell anemia
C. Iron deficiency anemia
D. Congenital heart disease




The correct answer is: C. Iron deficiency Anemia.

In general, cyanosis becomes apparent when,  the concentration of reduced hemoglobin in capillary blood exceeds 40 g/L (4 g/dL). It is the absolute,rather than the relative,quantity of reduced hemoglobin that is important in producing cyanosis. Thus, in a patient with severe anemia,the relative quantity of reduced hemoglobin in the venous blood may be very large when considered in relation to the total quantity of hemoglobin in the blood. However, since the concentration of the latter is markedly reduced, the absolute quantity of reduced hemoglobin may still be low, and, therefore, patients with severe anemia and even marked arterial desaturation may not display cyanosis. Conversely, the higher the total hemoglobin content, the greater the tendency toward cyanosis; thus, patients with marked polycythemia tend to be cyanotic at higher levels of Sao, than patients with normal hematocrit values.

CAUSES OF CYANOSIS

Central Cyanosis

1. Decreased arterial oxygen saturation
     A. Decreased atmospheric pressure- high altitude
     B. Impaired pulmonary function
          - Alveolar hypoventilation
          - Inhomogeneity in pulmonary ventilation and perfusion (perfusion of hypoventilated alveoli)
          - Impaired oxygen diffusion
     C. Anatomic shunts
         - Certain types of congenital heart disease
         - Pulmonary arteriovenous fistulas
         - Multiple small intrapulmonary shunts

    D. Hemoglobin with low affinity for oxygen

2. Hemoglobin abnormalities
    A. Methemoglobinemia-hereditary,acquired
    B. Sulfhemoglobinemia-acquired
    C. Carboxyhemoglobinemia (not true cyanosis)

Peripheral Cyanosis

A. Reduced cardiac output
B. Cold exposure
C. Redistribution of blood flow from extremities
D. Arterial obstruction
E. Venous obstruction

Ref: Harrison's 19th edition, Page 249

Dietary approaches to stop hypertension (DASH) approximately reduces systolic blood pressure by:

# Dietary approaches to stop hypertension (DASH) approximately reduces systolic blood pressure by:
a. 2-4mm Hg
b. 4-9mm Hg
c. 2-8mm Hg
d. 8-14mm Hg


The correct answer is D. 8-14 mm Hg.

Limitation of alcohol consumption will lower by 2-4mm Hg, physical activity will
reduce by 4-9mm Hg and dietary sodium reduction will lower by 2-8mm Hg. Adoption of DASH eating plan will reduce SBP by 8-14 mm Hg.

Ref: Burkett 12th ed, page number: 366

 # Cytomegalovirus that causes severe oral ulcers is also known as:
a. HHV 5
b. HHV4
c. HHV 2
d. HHV1



The correct answer is B. HHV4

HHV 4 is also known as cytomegalovirus, HHV 5 is Epstein barr, HHV 2 is herpes
simplex virus 2 and HHV 1 is herpes simplex virus 1. 

Ref: Burkett 12th ed, page number: 59

A patient with mitral valve replacement will require which of the following preoperatively

# A patient with mitral valve replacement  will require which of the following preoperatively?
A. Benzathine Penicillin
B. Tetracycline
C. Procaine penicillin
D. Vibramycin
 


The correct answer is A. Benzathine Penicillin.

Benzathine and procaine penicillins are formulated to delay absorption, resulting in prolonged blood and tissue concentrations. A single intramuscular injection of 1.2 million units of benzathine penicillin maintains serum levels above 0.02 mcg/mL for 10 days, sufficient to treat β-hemolytic streptococcal infection. After 3 weeks, levels still exceed 0.003 mcg/mL, which is enough to prevent β-hemolytic streptococcal infection. A 600,000 unit dose of procaine penicillin yields peak concentrations of 1–2 mcg/mL and clinically useful concentrations for 12–24 hours after a single intramuscular injection.

Reference: Basic and Clinical Pharmacology, 13th Edition, Katzung, Page 773

Petechial hemorrhage is characteristic of which of the following condition

 # Petechial hemorrhage is characteristic of which of the following condition?
A. Agranulocytosis
B. Neutropenia
 C. Pernicious anemia
 D. Thrombocytopenic purpura


The correct answer is D. Thrombocytopenic purpura.

Petechial purpura is minor bleeding into the dermis that is flat and non-blanching. Petechiae are typically found in patients with thrombocytopenia or platelet dysfunction. Palpable purpura occurs in vasculitis. Ecchymosis, or bruising, is more extensive bleeding into deeper layers of the skin. The
lesions are initially dark red or purple but become yellow as haemoglobin is degraded.

Reference: Davidson's Principles and Practice of Medicine, 22nd Edition, Page No. 1007

Bacteria found in gingivitis are localized in:

 # Bacteria found in gingivitis are localized in:
A. Connective tissue fibres
B. Gingival Sulcus
C. Alveolar bone
D. Periodontal ligament



The correct answer is B. Gingival sulcus.

The pathologic changes of gingivitis are associated with the presence of oral microorganisms attached to the tooth and perhaps in or near the gingival sulcus.

Reference: Carranza's Clinical Periodontology, 12th Edition, Page no: 219

Histological examination of the tissues in desquamative gingivitis reveals:

 # Histological examination of the tissues in desquamative gingivitis reveals:
A. Hyperkeratosis
B. Elongation of the rete pegs
C. Aggregations of giant cells
D. Local loss of the basement membrane


The correct answer is D. Local Loss of Basement Membrane.

Desquamative gingivits is histologically related to loss of basement membrane.

Reference: Carranza's Clinical Periodontology, 12th Edition, Page no: 263



One of the earlier signs of cavernous sinus thrombosis is due to deficit in the function of:

# One of the earlier signs of cavernous sinus thrombosis is due to deficit in the function of:
A. Trochlear nerve
B. Abducens nerve
C. Oculomotor nerve
D. Ophthalmic division of trigeminal nerve



The correct answer is B. Abducens nerve.

Because the abducens nerve (cranial nerve VI) is usually the first nerve to become involved due to its location in the lateral wall of the cavernous sinus, an early sign may be an internal strabismus.

Ref: ORAL AND MAXILLOFACIAL PATHOLOGY, A Rationale for Diagnosis and Treatment, Second Edition Page no 77

Exfoliative cytology is mainly used in the definitive diagnosis of the:

 # Exfoliative cytology is mainly used in the definitive diagnosis of the:
A. Oral cancer
B. Fungal infection
C. Vesiculobullous diseases
D. Viral infection


The correct answer is C. Vesiculobullous diseases.

It has been recognized that the exfoliative oral cytologic smear is also of value in the diagnosis of diseases other than carcinoma, particularly diseases which are characterized by the presence of certain specific cells. Thus, cytologic smears have been useful in the diagnosis of lesions of herpes simplex infection, herpes zoster, pemphigus vulgaris, benign familial pemphigus, keratosis follicularis, hereditary benign intraepithelial dyskeratosis, white sponge nevus, and pernicious and sickle cell anemia.

Reference: Shafer’s Textbook of ORAL PATHOLOGY, 7th Edition, Page No: 597


The prognosis of epidermoid carcinoma is least favorable

 # Of the following locations, the one in which the prognosis of epidermoid carcinoma is least favorable is:
A. Lower lip
B. Hard palate
C. Buccal mucosa
D. Posterior lateral border of tongue


The correct answer is D. Posterior lateral border of tongue.

The epidermoid carcinoma/ squamous cell carcinoma is the most common malignant neoplasm of the oral cavity. Although it may occur at any intraoral site, certain sites are more frequently involved than
others. Because of the differences in clinical appearance, the nature of the lesion and particularly the prognosis, it is well to describe the tumors individually, as they may arise in these various areas.

Of the areas of the oral cavity, the mortality rate is lowest for lip cancer (0.04 per 100,000) and highest for the tongue (0.7 per 100,000).

Reference: Shafer’s Textbook of ORAL PATHOLOGY, 7th Edition, Page No: 103

The most common development disorder affecting the tongue is:

 # The most common development disorder affecting the tongue is:
A. Median rhomboid glossitis
B. Abnormally fissured tongue
C. White spongy nevus
D. Black hairy tongue



The correct answer is B. Abnormally fissured tongue.

Fissured tongue is a condition frequently seen in the general population and it is characterized by grooves that vary in depth and are noted along the dorsal and lateral aspects of the tongue. Although a definitive etiology is unknown, a polygenic mode of inheritance is suspected because the condition is seen clustering in families who are affected.

Patients are usually asymptomatic, and the condition is initially noted on routine intraoral examination as an incidental finding. 

Reference: Shafer’s Textbook of ORAL PATHOLOGY, 7th Edition, Page No: 29
 

Ankylosis of the TMJ is best treated with:

 # Ankylosis of the TMJ is best treated with:
A. Exercise and massage
B. Sclerosing solutions
C. Antibiotics
D. Condylectomy



The correct answer is D. Condylectomy.

The treatment of TMJ ankylosis is always surgical. Early surgical correction of the ankylosed joint is highly desirable, if satisfactory function is to be regained. Surgical strategy adopted depends on the following:
a. Age of onset of ankylosis.
b. Extent of ankylosis.
c. Whether there is unilateral or bilateral involvement.
d. Associated facial deformity.

Surgical techniques
Number of techniques have been advocated by different surgeons. Critical analysis of all, filters only to three basic methods.
I : Condylectomy
II : Gap arthroplasty
III : Interpositional arthroplasty

Most surgical procedures can be done through a preauricular incision alone. The Popowich‘s incision is
chosen for its obvious advantages. Whenever required, additional submandibular incision can be used for fixation of the graft, etc.

Ref: Textbook of Oral and Maxillofacial Surgery, Neelima Anil Malik, 3rd Edition, Page 267


Best treatment for pericoronitis associated with impacted mandibular third molar is:

 # Best treatment for pericoronitis associated with impacted mandibular third molar is:
A. Irrigating under the operculum
B. Antibiotic and analgesic therapy
C. Extraction of impacted third molar
D. Operculectomy



The correct answer is C. Extraction of impacted third molar. 

Patients who have severe pericoronitis around an impacted mandibular third molar should not have the tooth extracted until the pericoronitis has been treated. Nonsurgical treatment should include irrigations, antibiotics, and removal of the maxillary third molar, if necessary, to relieve impingement on the edematous soft tissue overlying the mandibular impaction. If the mandibular third molar is removed in the face of severe pericoronitis, the incidence of complications increases. If the pericoronitis is mild and the tooth can be removed easily, then immediate extraction may be performed.

Pericoronitis is most common cause for removal of impacted mandibular third molars. It is recurrent
in nature and may cause the damage of bone around the 2nd and 3rd molars. So extraction of the involved tooth is the best treatment.

Anemia can manifest as all EXCEPT:

 # Anemia can manifest as all EXCEPT:
B. Vertigo
A. Headache
C. Delirium
D. Tinnitus


The correct answer is C. Delirium.

Headache and dizziness(vertigo) are common symptoms of anemia.

Tinnitus is the perception of sounds that occurs in the absence of external acoustic stimulus. The pathomechanism of tinnitus is thought to be complicated and therefore remains debatable. Among several risk factors, such as increased age, female gender, and hearing loss, anemia is especially related to pulsatile tinnitus due to an altered hemodynamic status although the prevalence of pulsatile tinnitus in anemia patients has not been reported in previous studies. Anemia results in decreased oxygen carrying capacity of the blood, which carries an associated risk of insufficient oxygen delivery and cellular hypoxia. The compensatory increased flow state and turbulence are perceived as tinnitus in the ear, and the recognition of a hyperdynamic circulatory state as the cause of the tinnitus avoids unnecessary diagnostic tests and is essential in determining appropriate treatment.

Ref: https://doi.org/10.1016/j.anl.2018.04.001

Initial control of hemorrhage after tooth extraction is achieved by:

 # Initial control of hemorrhage after tooth extraction is achieved by:
A. Placing figure of eight suture around the socket
B. Placing a moisture gauze over the extraction socket
C. Application of hydrogen peroxide pack
D. Prescribe antihemorrhagic drugs


The correct answer is B. Placing a moistened gauze over the extraction socket.

Initial control of hemorrhage is achieved by use of a moistened 2 × 2 inch gauze placed over the extraction socket. The gauze should be positioned such that when the patient closes his or her teeth together, it fits into the space previously occupied by the crown of the tooth. Biting of teeth together places pressure on the gauze, and the pressure is then transmitted to the socket. This pressure results in hemostasis. If the gauze is simply placed on the occlusal table, the pressure applied to the bleeding socket is insufficient to achieve adequate hemostasis. A larger gauze sponge (4 × 4 inches) may be required if multiple teeth have been extracted or if the opposing arch is edentulous.

Reference: CONTEMPORARY ORAL AND MAXILLOFACIAL SURGERY, Sixth Edition, Page NO 118

Dumble-bell shaped swelling is characteristic of which type of odontogenic space infection:

# ‘Dumble-bell’ shaped swelling is characteristic of which type of odontogenic space infection?
A. Submandibular space infection
B. Buccal space infection
C. Submasseteric space infection
D. Temporal space infection


The correct answer is D.Temporal Space Infection.

"Dumb-bell" shaped swelling is seen in deep temporal space infection because of zygomatic arch, swelling is seen superior and inferior to zygomatic arch resulting in Dumb-bell shaped swelling.

Presence of portwine stains, gingival overgrowth and convulsive disorders

 # Which of the following is characterized by the presence of portwine stains, gingival overgrowth and convulsive disorders?
A. Sturge Weber syndrome
B. Witkop syndrome
C. Hunter syndrome
D. Fanconi syndrome



The correct answer is A. Sturge Weber Syndrome.

Encephalotrigeminal Hemangiomatosis
(Sturge-Weber syndrome)
The facial cutaneous capillary venous angiomas (or port-wine nevi) are usually the first component
of the syndrome to be observed, at birth, and are confined almost exclusively to the skin area supplied by the trigeminal nerve. Neurologic manifestations are among the most characteristic features of the disease and consist of convulsive disorders and spastic hemiplegia with or without mental retardation. Occasionally, angiomatous lesions also involve the gingiva and buccal mucosa.

Reference: Shafer’s Textbook of ORAL PATHOLOGY, 7th Edition, Page No: 149




Undifferentiated mesenchymal cells around blood vessels are known as:

# Undifferentiated mesenchymal cells around blood vessels are known as:
A. Histiocytes
B. Pericytes
C. Fibroblast
D. Osteoblast



The correct answer is B. Pericytes.

Experimental studies have shown that a population of progenitor cells with the potential to differentiate into several distinct mesenchymal cell types can be isolated from the periodontal ligament. In cell culture, periodontal ligament stem cells can differentiate into cells that form bone, cementum, cartilage, fat, muscle, and neuron- and glial-like cells. Recent work indicates that perivascular cells (pericytes) associated with the microvasculature of alveolar bone and periodontal ligament of mice can differentiate into osteoblasts, cementoblasts, cementocytes, and periodontal ligament fibroblasts in
untreated animals, as well as after injury of the periodontium.

Reference: Fundamentals of Oral Histology and Physiology, Arthur R. Hand, 2014, Page no 128


The protein content of a keratocyst is found to be:

# The protein content of a keratocyst is found to be:
A. less than 4 gm/dL
B. 6 mg/dL
C. Equal to serum protein
D. More than serum protein



The correct answer is A. less than 4 gm/dL.

Aspirational biopsy of odontogenic keratocysts contains a greasy fluid which is pale in colour and contains keratotic squames. Protein content of cyst fluid below 4g% is diagnostic of odontogenic keratocysts. Smaller and unilocular lesions resembling other types of cysts may require a biopsy to confirm the diagnosis. On a CT scan, the radiodensity of a keratocystic odontogenic tumour is about 30 Hounsfield units, which is about the same as ameloblastomas. However, ameloblastomas show more bone expansion and seldom show high density areas.

Reference: Wikipedia

Familial multilocular cystic disease of the jaws

 # Which of the following is also known as familial multilocular cystic disease of the jaws?
A. Osteopetrosis
B. Cleidocranial dysostosis
C. Hemifacial microsomia
D. Cherubism


The correct answer is D. Cherubism.

Cherubism, a non-neoplastic hereditary bone lesion that is histologically similar to central giant cell granuloma, affects the jaws of children bilaterally and symmetrically, usually producing the so-called cherubic look (Fig. 17-13). The disease was first described in 1933 by Jones, who called it familial multilocular disease of the jaws. The term ‘cherubism’, was introduced by Jones and others to describe the clinical appearance of affected patients. According to the WHO classification, cherubism belongs to a group of non-neoplastic bone lesions affecting only the jaws. It is a rare, benign condition with autosomal dominant inheritance, and it is one of the very few genetically determined osteoclastic lesions in the human body. It appears to have 100% penetrance in males and only 50–70% penetrance in females. There is great variation in the clinical expression.

Reference: Shafer’s Textbook of ORAL PATHOLOGY, 7th Edition, Page No: 715


Cause of osteogenesis imperfecta is:

# Cause of osteogenesis imperfecta is:
A. Defect in type I collagen
B. Defect in type II collagen
C. Defect in maturation process
D. Defect in calcification process


The correct answer is A. Defect in type I collagen.

Osteogenesis imperfecta (OI) is a serious disease, the molecular pathogenesis of which is being elucidated and it bears a superficial relatedness to dentinogenesis imperfecta, a milder condition affecting mesodermal tissues. It is a condition resulting from abnormality in the type I collagen, which most commonly manifests as fragility of bones. Although osteogenesis imperfecta is generally recognized as representing a hereditary autosomal dominant characteristic, autosomal recessive and nonhereditary types also occur.

Reference: Shafer’s Textbook of ORAL PATHOLOGY, 7th Edition, Page No: 699


Dysplastic changes, carcinoma in situ or even early invasive cancer is seen in:

# Which of the following clinical lesions is most likely to harbor dysplastic changes, carcinoma in situ or even early invasive cancer?
A. Erythroplakia
B. Lichen planus
C. Leukoplakia
D. Stomatitis nicotiana


The correct answer is A. Erythroplakia.

Erythroplakia
(Erythroplasia of Queyrat)
Whilst leukoplakia is a relatively common condition, erythroplakia is rare. In contrast to leukoplakia, erythroplakia is almost always associated with premalignant changes histologically and is, therefore, the most important precancerous lesion.

The high rate of premalignant and malignant changes noticed in erythroplakia is true for all clinical varieties of this lesion and not solely a feature of speckled erythroplakia. Different studies have demonstrated that 80–90% of erythroplakias are histopathologically either severe epithelial dysplasia, carcinoma in situ, or invasive carcinoma.  

 Reference: Shafer’s Textbook of ORAL PATHOLOGY, 7th Edition, Page No: 95


Most sensitive to radiation induced cancer?

 # Which of the following is the most sensitive to radiation induced cancer?
A. Nerves
B. Female breast
C. Thyroid
D. Skin



The correct answer is B. Female breast.

Susceptibility of Different Organs to Radiation-Induced Cancer
High: Colon, Stomach, Lung, Bone marrow (leukemia), female breast
Intermediate: Bladder, Liver, Thyroid
Low: Bone surface, Brain, Salivary glands, skin

Reference: Oral Radiology Principles and Interpretation, 7th Edition, Page no 26


 

Tetanus is due to:

# Tetanus is due to:
A. Exotoxin fixed to motor end plate
B. Endotoxin fixed to motor end plate
C. Circulating exotoxin
D. Circulating endotoxin


The correct answer is C. Circulating exotoxin.

C. tetani is an anaerobic, gram-positive, spore-forming rod whose spores are highly resilient and can survive readily in the environment throughout the world. Spores resist boiling and many disinfectants. In addition, C. tetani spores and bacilli survive in the intestinal systems of many animals, and fecal carriage is common. The spores or bacteria enter the body through abrasions, wounds, or (in the case of neonates) the umbilical stump. Once in a suitable anaerobic environment, the organisms grow, multiply, and release tetanus toxin, an exotoxin that enters the nervous system and causes disease. Very low concentrations of this highly potent toxin can result in tetanus (minimum lethal human dose, 2.5 ng/kg).

Genome sequencing of C. tetani has allowed identification of several exotoxins and virulence factors. Only those bacteria producing tetanus toxin ( tetanospasmin) can cause tetanus. Although closely related to the botulinum toxins in structure and mode of action, tetanus toxin undergoes retrograde transport into the central nervous system and thus produces clinical effects different from those caused by the botulinum toxins,  which remain at the neuromuscular junction.

Reference: Harrison's Principles of Internal Medicine, 19th Edition, Page no: 984

The potency of the midazolam is:

 # The potency of the midazolam is:
A. Thrice that of diazepam
B. Twice that of diazepam
C. 10 times that of diazepam
D. 5 times that of diazepam


The correct answer is A. Thrice that of diazepam.

Midazolam This BZD is water soluble, nonirritating to veins, faster and shorter acting (t½ 2 hours) and 3 times more potent than diazepam. Fall in BP is somewhat greater than with diazepam. It is being preferred over diazepam for anaesthetic use: 1–2.5 mg i.v. followed by 1/4th supplemental doses. Also used for sedation of intubated and mechanically ventilated patients and in other critical care anaesthesia as 0.02–0.1 mg/kg/hr continuous i.v. infusion.

Reference: Essentials of Medical Pharmacology, Seventh Edition, KD Tripathi, Page 383



Saliva plays a vital role in the:

 # Saliva plays a vital role in  the ________ of a complete denture.
A. Retention
B. Stability
C. Support
D. Esthetics


The correct answer is A. Retention.

Sufficient amount of saliva is necessary for the maintenance of oral health and comfort. In this respect,
saliva is particularly important in wearers of removable dentures to protect the oral mucosa from mechanical irritation and infections and to achieve retention in complete dentures. The normal unstimulated salivary flow rate is 0.38±0.21 ml/min. Impaired salivary secretion or xerostomia is likely, if the unstimulated flow rate is less than 0.12 ml/min. Of the whole unstimulated saliva, 40 percent is derived from the submandibular glands and 8 percent from mucosal glands. The normal stimulated salivary flow rate is less than 0.60 ml/min of the whole stimulated saliva and 50 to 65 percent is
derived from the parotid glands.

Reference: Textbook of Complete Denture PROSTHODONTICS, Page NO. 3

Rheumatoid arthritis in children is known as:

 # Rheumatoid arthritis in children is known as:
A. Still’s disease
B. Kamura’s disease
C. Hansen’s disease
D. Degenerative joint disease


The correct answer is A. Still's disease.

Inflammatory arthritis occurs rarely in children. Several distinct subtypes are recognised. Systemic
juvenile idiopathic arthritis (JIA; formerly known as Still’s disease) is a systemic disorder characterised by fever, rash, arthritis, hepatosplenomegaly and serositis in association with a raised ESR and CRP. Autoantibody tests are negative.

Reference: Davidson’s Principles and Practice of Medicine, 22nd Edition 2014, Page no: 1104

Diabetes insipidus occur due to lack of:

# Diabetes insipidus occur due to lack of:
A. Insulin
B. Antidiuretic hormone
C. ACTH
D. Thyroxin



The correct answer is B. Antidiuretic hormone.

The neurohypophysis, or posterior pituitary, is formed by axons that originate in large cell bodies in the supraoptic and paraventricular nuclei of the hypothalamus. It produces two hormones: ( 1 ) arginine
vasopressin (AVP), also known as antidiuretic hormone, and (2) oxytocin. AVP acts on the renal tubulω to reduce water loss by con centrating the urine. Oxytocin stimulates postpartum milk letdown in response to suckling. A deficiency of AVP secretion or action causes diabetes insipidus (DI),a syndrome characterized by the production of large amounts of dilute urine. Exιessive or inappropriate AVP production impairs urinary water excretion and predisposes to hyponatremia if water intake is not reduced in parallel with urine output.

Reference: Harrison's Principles of Internal Medicine, 19th Edition, Page no: 2274

In jaundice there is an unconjugated hyperbilirubinemia which is most likely due to:

 # In jaundice there is an unconjugated hyperbilirubinemia which is most likely due to:
A. Hepatitis
B. Cirrhosis
C. Obstruction of bile in canaliculi
D. Increased breakdown of red cells



The correct answer is D. Increased breakdown of red cells.

Hemolysis Increased destruction of erythrocytes leads to increased bilirubin turnover and unconjugated hyperbilirubinemia; the hyperbilirubinemia is usually modest in the presence of normal liver function.
In particular,the bone marrow is only capable of a sustained eightfold increase in erythrocyte production in response to a hemoIytic stress. Therefore, hemolysis alone cannot result in a sustained hyperbilirubinemia of more than -68 μmol/L (4 mg/dL) . Higher values imply concomitant hepatic dysfunction. When hemolysis is the only abnormality in an otherwise healthy individual, the result is a purely unconjugated hyperbilirubinemia,with the direct-reacting fraction as measured in a typical clinical laboratory being less or equal to 15% of the total serum bilirubin.

Reference: Harrison's Principles of Internal MEDICINE, 19th Edition Page no: 2000

Pernicious anemia is due to deficiency of:

# Pernicious anemia is due to deficiency of:
A. Iron
B. Cobalamine
C. Folic acid
D. Niacin



The correct answer is B. Cobalamine.

Pernicious anemia is a relatively common chronic hematologic disease. It is an adult form of anemia that is associated with gastric atrophy and a loss of intrinsic factor production in gastric secretions and a rare congenital autosomal recessive form in which intrinsic factor (IF) production is lacking without gastric atrophy. The term pernicious anemia is reserved for patients with vitamin B12 deficiency due to a lack of production of IF in the stomach. Intrinsic factor in gastric secretions is necessary for the absorption of dietary vitamin B12. Vitamin B12, a substance now thought to be synonymous with the ‘erythrocyte-maturing factor’ or ‘hemopoietic principle’ and present in many foods, particularly liver, beef, milk and dairy products. Body stores of the vitamin usually exceed 1000 mcg and the daily requirement is about 1 mcg.

Reference: Shafer’s Textbook of ORAL PATHOLOGY, Seventh Edition, Page 762

Common site of carcinoma of tongue is:

 # Common site of carcinoma of tongue is:
A. Apical
B. Lateral borders
C. Dorsum
D. Posterior 1/3rd 



The correct answer is B. Lateral borders.

The typical lesion develops on the lateral border or ventral surface of the tongue. When, in rare cases, carcinoma occurs on the dorsum of the tongue, it is usually in a patient with a past or present history of syphilitic glossitis. In a series of 1,554 cases of carcinoma of the tongue reported by Frazell and Lucas, only 4% occurred on the dorsum. The lesions on the lateral border are rather equally distributed between the base of the tongue, the anterior third and the mid portion, although in the above series 45% of cases occurred on the middle third. Lesions near the base of the tongue are particularly insidious, since they may be asymptomatic until far advanced. Even then the only presenting manifestations may be a sore throat and dysphagia. The specific site of development of these tumors is of great significance, since the lesions on the posterior portion of the tongue are usually of a higher grade of malignancy, metastasize earlier and offer a poorer prognosis, especially because of their inaccessibility for treatment.

Reference: Shafer’s Textbook of ORAL PATHOLOGY, Seventh Edition, Page no: 116