Stunned pulp is:

 # Stunned pulp is:

A. Stunning appearance on radiograph

B. Does not respond to vitality tests 6-8 weeks after trauma

C. Necrosed pulp

D. Hyperaemic pulp

The correct answer is B. Does not respond to vitality tests 6-8 weeks after trauma.

Diagnosis of traumatized tooth:

- Diagnosis is made from the patient's history, visual examination, radiographs, electric pulp test, and the thermal test. Following fracture of the root, the reaction to tests of pulp vitality may be negative for as long as 6-8 weeks; that is, the pulp is stunned.

- A stunned tooth due to injury responds within 6 weeks. If it does not respond after that, pulp may be undergoing necrotic changes.

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Feature of chronic extravascular hemolysis

 # Which one of the following is a feature of chronic extravascular hemolysis? 

a. Raised serum conjugated bilirubin 

b. Low reticulocyte count 

c. Hypocellular bone marrow 

d. Gall stones

The correct answer is D. Gall stones.

Hemolytic anemia is a form of anemia due to hemolysis, the abnormal breakdown of red blood cells (RBCs), either in the blood vessels (intravascular hemolysis) or elsewhere in the human body (extravascular). This most commonly occurs within the spleen, but also can occur in the reticuloendothelial system or mechanically (prosthetic valve damage). Hemolytic anemia accounts for 5% of all existing anemias.  It has numerous possible consequences, ranging from general symptoms to life-threatening systemic effects. The general classification of hemolytic anemia is either intrinsic or extrinsic. Treatment depends on the type and cause of the hemolytic anemia.

Symptoms of hemolytic anemia are similar to other forms of anemia (fatigue and shortness of breath), but in addition, the breakdown of red cells leads to jaundice and increases the risk of particular long-term complications, such as gallstones and pulmonary hypertension. 

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Iron absorption will be increased in:

 # Iron absorption will be increased in: 

a. Pregnancy 

b. Chronic inflammation 

c. Iron overload 

d. Phosphates

The correct answer is A. Pregnancy.

Factors that increase iron absorption from GI tracts are:

• Dietary factors

• Increased heme iron (particularly in meat)

• Ferrous iron salts

• GI factors

         – Acid pH

• Increased requirement:

         – Iron deficiency

         – Increased erythropoiesis

         – Pregnancy

         – Hypoxia

Factors that decrease iron absorption are:

• Ferric iron salts

• Malabsorption

• Proximal bowel resection

• Presence of oxalates, phytates and phosphates in diet

• Inflammatory disorders (due to increased hepcidin level)

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First stage of iron deficiency:

 # Which is the first stage of iron deficiency? 

a. Negative iron balance 

b. Decreased iron stores 

c. Decrease MCV 

d. Decrease in Hemoglobin

The correct answer is A. Negative Iron Balance.

“Negative iron balance” describes a state in which body iron content is decreasing, secondary to relative decreases in iron intake and/or relative increases in iron losses. Over time, negative iron balance can progress to functional and absolute iron deficiency and anemia.

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