Why is morphine contraindicated in maxillofacial injury or head injury?

 # In patients with maxillofacial injury, narcotics like morphine are contraindicated because:

A. Morphine causes miosis

B. Morphine causes mydriasis

C. Morphine is respiratory irritant

D. Morphine is circulatory depressant

The correct answer is A. Morphine causes miosis.

Miosis masks the neurological signs of cerebral hemorrhage.

  Morphine is a phenanthrene derivative opioid analgesic. It is contraindicated in head injuries due to:

- Retention of carbondioxide leading to increased intracranial pressure

- exaggerated depression of respiration and the potential need to control ventillation of the patient must be considered

- vomitting, miosis (miosis will interrupt in monitoring the eye signs in case of probable head injury in the patients of maxillofacial injury), and altered mental state interfere with assessment of prognosis in patients with head injury

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‘Chicken-wire’ appearance of enlarged bone marrow spaces is seen in:

 # ‘Chicken-wire’ appearance of enlarged bone marrow spaces is seen in:

A. Fetal alcohol syndrome

B. Sickle cell anemia

C. Hemophilia A

D. Beta thalassemia major

The correct answer is D. Beta thalassemia major.

Radiographic changes of thalassemia include generalized rarefaction of alveolar bone, chicken-wire appearance of enlarged marrow spaces and coarse trabeculation. In the skull, proliferation of marrow may completely erode the cortex, leaving only periosteum, and produce a ‘hair-on-end’ radiographic appearance.

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Enamel can act in a sense like a:

# Enamel can act in a sense like a:

A. Permeable membrane

B. Impermeable membrane

C. Semipermeable membrane

D. Infrapermeable membrane

 

The correct answer is C. Semipermeable membrane.

Another physical property of enamel is its permeability. It has been found with radioactive tracers that the enamel can act in a sense like a semipermeable membrane, permitting complete or partial passage of certain molecules: 14C-labeled urea, I, etc. The same phenomenon has also been demonstrated by means of dyes.

Reference: Orban's

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All primary teeth would have begun to calcify by:

 # All primary teeth would have begun to calcify by:

A. 14 weeks of intrauterine life

B. 18-20 weeks of intrauterine life

C. 6 months of gestation

D. 6 months of age

The correct answer is B. 18-20 weeks of intrauterine life.

Calcification of the primary teeth begins in utero from 13 to 16 weeks postfertilization. By 18 to 20 weeks, all the primary teeth have begun to calcify. Primary tooth crown formation takes only about 2 to 3 years from initial calcification to root completion. However, mineralization of the permanent dentition is entirely postnatal, and the formation of each tooth takes about 8 to 12 years.

Reference: Wheeler's

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