An asymptomatic tooth has deep caries on occlusal surface. Radiograph shows radiopaque mass at apex of the tooth. This mass is most likely to be:

 # An asymptomatic tooth has deep caries on occlusal surface. Radiograph shows radiopaque mass at apex of the tooth. This  mass is most likely to be:

A. Cementoma

B. Condensing osteitis

C. Chronic apical periodontitis

D. Acute apical periodontitis

The correct answer is B. Condensing osteitis.

In condensing osteitis, radiographs demonstrate radiopacity which is not attached to tooth, entire root outline is visible, lamina dura intact and periodontal ligament is widened. These features differentiate it from cementoblastoma, in which the radiopacity is attached to tooth, lamina dura absent and root outline is not visible. In condensing osteitis the tooth may be vital or non-vital.

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In a leukemic patient, bleeding does not stop because:

 # In a leukemic patient, bleeding does not stop because:

A. Decreased platelet count 

B. Increased WBC count

C. Decreased calcium level

D. Decrease in coagulation level

The correct answer is A. Decreased Platelet Count

The sign and symptoms of acute leukemia result from either bone marrow suppression or infiltration

of leukemic cells into organs tissues. These changes cause anemia, thrombocytopenia and a decrease in

neutrophils. Thrombocytopenia causes spontaneous bleeding such as petechiae, ecchymoses, epistaxis,

melena. It may necessary to perform surgery on patients with platelet counts in the range of 25,000

because of the difficulty in achieving platelet levels due to circulating platelet antibodies.

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Diamond Blackfan anemia is characterized by:

 # Diamond Blackfan anemia is characterized by:

A. Inherited thrombocytopenia 

B. Inherited leucopenia

C. Erythroid aplasia

D. All of the above

The correct answer is C. Erythroid aplasia.

Diamond–Blackfan anemia (DBA) is a congenital erythroid aplasia that usually presents in infancy. DBA causes low red blood cell counts (anemia), without substantially affecting the other blood components (the platelets and the white blood cells), which are usually normal. This is in contrast to Shwachman–Bodian–Diamond syndrome, in which the bone marrow defect results primarily in neutropenia, and Fanconi anemia, where all cell lines are affected resulting in pancytopenia.

First noted by Hugh W. Josephs in 1936, the condition is however named for the pediatricians Louis K. Diamond and Kenneth Blackfan, who described congenital hypoplastic anemia in 1938. 

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Reduction of flow of saliva is not generally seen in:

# Reduction of flow of saliva is not generally seen in:

A. Elderly diabetes

B. Patient undergoing radiation

C. Patient suffering from parkinsonism

D. Patient of Phenothiazine drugs

The correct answer is C. Patient suffering from Parkinsonism.

Xerostomia : It is the subjective clinical condition of less than normal amount of saliva. It is dryness of mouth, which is a clinical manifestation of salivary gland dysfunction.

Causes:

- Radiation induced

- Pharmacologically induced xerostomia—there are about 500 drugs which can cause xerostomia. The classes of drugs which cause xerostomia include anticonvulsants, antiemetics, antihistaminics, anti-hypertensives and antispasmodics. The mode of action for decreased salivary flow is generally related to the para-sympathetic activity, usually an antimuscarine effect.

- Smoking, Mouth breathing

- Developmental—developmental abnormalities of salivary glands, tumors, autoimmune states and certain diseases which affect afferent or efferent portions of neural transmission reflex

- Systemic alternations resulting in xerostomia 

• Nutritional—certain deficiency states like pernicious anemia, iron deficiency anemia and deficiency of

vitamin A and hormones can cause xerostomia.

• Fluid loss—fluid loss associated with hemorrhage, sweating, diarrhea, vomiting.

• Diabetes mellitus—it is associated with xerostomia.

• Sjögren syndrome—xerostomia is also common in Sjögren syndrome.

• Other disease—systemic diseases, which are accompanied by high temperature and dehydration, usually result in diminished salivation. Xerostomia may also be found in HIV infection, sarcoidosis, and graft versus host resistance.

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