Osteomyelitis in early stage on radiograph appear as:

 # Osteomyelitis in early stage on radiograph appear as:
A. Blurring of trabeculae
B. Dense radiopaque areas
C. Radiolucent foci
D. Formation of sequestrum


The correct answer is A. Blurring of trabeculae. 

Osteomyelitis is defined as inflammation of bone and its bone marrow. Acute osteomyelitis progresses rapidly and demonstrates limited radiographic evidence until 1-2 weeks. The earliest change noticed is fuzziness and indistinct trabeculae. Chronic osteomyelitis appears as moth eaten radiolucencies in the bone, along with appearance of radiopaque sequestrum. 

In pantomograph, if patient chin is placed anterior to the focal trough, the structures appears to be:

 # In pantomograph, if patient chin is placed anterior to the focal trough, the structures appears to be:
A. Blurred and diminished
B. Blurred and magnified
C. Either magnified or diminished
D. Only blurred



The correct answer is A. Blurred and diminished.

Anatomic structures present within the focal trough are well defined on panoramic radiographers. If the chin is placed anterior to the focal trough, the structures appear to be blurred and diminished. If the chin is placed posterior to the focal trough, structures appear blurred and magnified. 

Ball in hand appearance is seen in:

 # Ball in hand appearance is seen in:
A. Sialadenosis
B. Benign tumor of salivary gland
C. Sialadenitis
D. Sjogren’s syndrome



The correct answer is B. Benign tumor of salivary gland.

Benign tumors may present as low-intensity (dark) or high-intensity (light) tissue signals on MRI, although the relative intensity of the signal may indicate the presence of lipid, vascular, or fibrous
tissues. Sialography may suggest a space-occupying mass when the ducts are compressed or smoothly displaced around the lesion (the “ball-in-hand” appearance).

Ulcers on palate, splenomegaly and lymphadenopathy with positive heterophile agglutination test

 # A 20-year-old female reports with ulcers on palate, splenomegaly and lymphadenopathy. Serum examination reveals positive heterophile agglutination test. What is the diagnosis? 
A. Rickettsia 
B. Measles 
C. Infectious Mononucleosis 
D. Chicken pox 


The correct answer is C. Infectious mononucleosis.

INFECTIOUS MONONUCLEOSIS 
• It is also called Glandular fever, kissing disease.

Clinical features: 
• Age: Children or young adults with peak incidence 15-20 yrs. In children, most cases are asymptomatic. 
• Fever, sore throat, headache, chills, nausea, vomiting, lymphadenopathy & hepatosplenomegaly are present. 
• Cervical lymph nodes are usually the 1st to exhibit enlargement. 

Oral manifestation: 
• Acute gingivitis & stomatitis present. 
• White grey membrane formation on various areas of oral & pharyngeal mucosa occurs. 
• Palatal Petechiae are often diagnostic. 
- Pin-point in size. 
- Present especially on soft palate & its junction with hard palate. 
- May help as an early diagnostic sign. 

Lab findings: 
• +ve Paul Bunnel test (Heterophile 'Ab' test) 
- Characteristic & pathognomonic of disease
- Heterophile 'Ab' titre increased up to 1: 4096 
• Atypical lymphocytosis: More than 50% lymphocytosis of which > 10% atypical 
• Thrombocytopenia 
• Antibodies to EBV present 
• Normal ESR 

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