Orthodontic Treatment at Damak Hospital by Dr. Raman Dhungel

 

Drug of choice for focal seizure is:

 # Drug of choice for focal seizure is:

A. Phenytoin

B. Gabapentin

C. Lorazepam

D. Levetiracetam

The correct answer is D. Levetiracetam.

Levetiracetam is the drug of choice for focal (partial) onset seizures.

Current clinical practice and guidelines (including ILAE and NICE) prefer Levetiracetam (or Lamotrigine) as a first-line monotherapy due to its broad-spectrum efficacy, rapid onset, linear pharmacokinetics, minimal drug interactions, and superior safety profile compared to older agents.

Breakdown of the options:

• Levetiracetam: First-line drug of choice for newly diagnosed focal seizures (both with and without focal-to-bilateral tonic-clonic evolution).

• Phenytoin: Classic first-line agent for focal seizures, but largely replaced by newer anticonvulsants due to zero-order kinetics, severe drug-drug interactions, and adverse effects (e.g., gingival enlargement, nystagmus, ataxia).

• Gabapentin: Used primarily as adjunctive (add-on) therapy for focal seizures, or for neuropathic pain.

• Lorazepam: First-line drug of choice for acute emergency management of status epilepticus, not long-term monotherapy.

Pretreatment and Immediately after Orthodontic Bonding - Intra Oral Images Dr. Raman Dhungel, BDS, MDS (Orthodontics)

Which of the following is not an antigen-presenting cell?

 # Which of the following is not an antigen-presenting cell?

A. B cell

B. Dendritic cell

C. T cell

D. Macrophage

The correct answer is C. T cell.

Explanation:

Professional Antigen-Presenting Cells (APCs) are specialized immune cells that process and display foreign antigens complexed with Major Histocompatibility Complex (MHC) class II molecules on their surfaces. Their primary role is to present these antigens to T cells to trigger an immune response.

The classical professional APCs are:

Dendritic cells: The most potent APCs, crucial for initiating primary immune responses by activating naive T cells.

Macrophages: Phagocytes that engulf pathogens and present antigens to T cells to sustain ongoing immune responses.

B cells: Internalize antigens via their specific surface antibodies and present them to helper T cells to receive the signals necessary for antibody production.

T cells, conversely, are the "responders." They use their T cell receptors (TCRs) to recognize the antigens presented by the APCs. They do not serve the primary function of capturing and presenting antigens.

Ringer lactate does not contain:

 # Ringer's lactate does not contain:

A. Magnesium

B. Chloride

C. Potassium

D. Sodium

The correct answer is Magnesium.

Ringer's lactate (also known as Hartmann's solution or sodium lactate solution) is an isotonic crystalloid fluid used for intravenous resuscitation and fluid replacement. It is formulated to closely mimic the electrolyte concentration of human blood plasma, but it does not contain magnesium.

Ideally a malocclusion should be treated between the age of:

 # Ideally a malocclusion should be treated between the age of:

A. 5 and 8 years

B. 8 and 10 years

C. 10 to 12 years

D. The age at which a malocclusion is treated depends on the problem involved

The correct answer is: D. The age at which a malocclusion is treated depends on the problem involved.

Explanation: There is no single ideal age to treat all malocclusions. The optimal timing depends on the type and severity of the malocclusion, the patient's growth status, and the treatment objectives.

Examples:

• Early (5–8 years):
  • Crossbites
  • Functional shifts
  • Harmful oral habits
  • Severe skeletal Class III requiring interceptive treatment
  • 
    
• Mixed dentition (8–10 years):
  • Severe crowding
  • Ectopic eruption
  • Functional Class II correction in selected cases
  • 
    
• Late mixed/early permanent dentition (10–12 years):
  • Most comprehensive orthodontic treatments
  • Class II correction during the pubertal growth spurt
  • Alignment after eruption of permanent teeth
  • 
    
• Adolescence or adulthood:
  • Comprehensive orthodontic treatment
  • Orthognathic surgery for severe skeletal discrepancies (after growth completion)

Nepal Medical Council Special Examination Sample Questions - Orthodontics and Dentofacial Orthopedics

NMC Special Licence Exam: Orthodontics (MDS)

100 Interactive Questions including Image-based MCQs.

Instructions

• ✔️ Total Questions: 100
• ✔️ Level: Masters of Dental Surgery (MDS)
• ✔️ Explanations provided after each answer.
• ✔️ Click an option to lock in your answer.

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Explanation:

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The Nine Types of GIC - Types of Glass Ionomer Cement Mnemonics

The 9 Types of GIC

Glass Ionomer Cements classified by application. Use this highly effective memory tool to ace your dental exams!

The Ultimate Mnemonic

Little Rest😴 between fussy😒 orthodontic🦷 class🏫, fluorishes✨ artistic🎨 children!🧒

Type I

🔗

Little

stands for

Luting Cement

Used for cementation of crowns, bridges, and inlays.

Type II

🦷

Rest

stands for

Restorative

Used for direct restorations in anterior teeth and cervical lesions.

Type III

🛡️

between

stands for

Bases & Liners

Used as a protective layer under composite or amalgam.

Type IV

🛑

fussy

stands for

Pit & Fissure Sealant

Used to seal deep grooves to prevent caries.

Type V

😬

orthodontic

stands for

Orthodontic Cement

Used for cementing orthodontic bands and brackets.

Type VI

🏗️

class

stands for

Core Build-up

Highly reinforced GIC used to build up severely broken teeth.

Type VII

✨

fluorishes

stands for

High Fluoride Releasing

Command set materials specifically for high caries risk patients.

Type VIII

🛠️

artistic

stands for

ART

Atraumatic Restorative Treatment for field dentistry without drills.

Type IX

🧸

children

stands for

Pediatric GIC

Specifically formulated for restoring deciduous (baby) teeth.

www.dentaldevotee.com

Which molecular signaling pathway is primarily responsible for the differentiation of osteoclasts during orthodontic tooth movement?

 # Which molecular signaling pathway is primarily responsible for the differentiation of osteoclasts during orthodontic tooth movement?

A. Wnt/Beta-catenin pathway.

B. Notch signaling pathway.

C. BMP-2 signaling pathway.

D. RANK/RANKL/OPG pathway.

The correct answer is D. RANK/RANKL/OPG pathway.

During orthodontic tooth movement (OTM), mechanical loading creates zones of compression within the periodontal ligament (PDL). In these compression zones, local osteocytes and PDL fibroblasts upregulate the expression of RANKL (Receptor Activator of Nuclear Factor kappa B Ligand) and downregulate OPG (Osteoprotegerin), which acts as a decoy receptor.

RANKL binds to its receptor, RANK, located on the surface of circulating osteoclast precursor cells (monocyte/macrophage lineage). This binding triggers downstream intracellular cascades—primarily via the recruitment of TRAF6 and activation of NF-kappaB and NFATc1—driving the fusion, differentiation, and activation of these precursors into mature, bone-resorbing osteoclasts.

Why the other options are incorrect:

• A. Wnt / beta-catenin pathway: This pathway is heavily involved in mechanical sensing and osteoblastogenesis (bone formation). Activation of this pathway leads to the differentiation of mesenchymal stem cells into osteoblasts on the tension side of OTM.

• B. Notch signaling pathway: While it plays broad roles in cell fate determination and bone homeostasis, it is not the primary mechanism responsible for targeted osteoclast differentiation under orthodontic load.

• C. BMP-2 signaling pathway: Bone Morphogenetic Protein-2 is a potent initiator of the osteogenic lineage, driving the differentiation of osteoblasts and bone matrix deposition rather than bone resorption.

Stable internal landmark for superimposition in the mandible

 # According to Bjork's implant studies, which of the following is considered a stable internal landmark for superimposition in the mandible?

A. The tip of the chin (pogonion).

B. The posterior border of the ramus.

C. The inner cortical border of the symphysis.

D. The lower border of the mandible.

The correct answer is C. The inner cortical border of the symphysis.

According to Arne Björk’s landmark implant studies utilizing metallic implants, the stable internal structures of the mandible that show no structural changes due to growth or remodeling—and are therefore used for longitudinal cephalometric superimposition—include:

1. The inner cortical border of the symphysis (specifically the anterior contour of the inner cortical wall).

2. The contour of the mandibular canal.

3. The trabecular structures related to the canal (the "cribriform plate" of the lower jaw).

4. The outline of the unerupted third molar germ (prior to the initiation of root formation).

Why the other options are incorrect:

• A, B, and D are all external surfaces of the mandible. Björk demonstrated that the external surfaces undergo significant, variable patterns of apposition and resorption during growth. For example, the lower border of the mandible (D) undergoes resorption posteriorly and apposition anteriorly in forward-rotating growers, while the posterior border of the ramus (B) undergoes extensive apposition to allow for the anteroposterior lengthening of the mandibular body.