PGCEE MDS 2022: Jug handle view is another name for:

 # Jug handle view is another name for:

a. occipitomental view 

b. submentovertex view 

c. lateral cephalogram 

d. lateral oblique view

The correct answer is B. Submentovertex view.

Submentovertex projection or jug handle view: 

 The image receptor is positioned parallel to the patient’s transverse plane and perpendicular to the midsagittal and coronal planes. To achieve this position, the patient’s neck is extended as far backward as possible, with the canthomeatal line forming a 10-degree angle with the image receptor.

PGCEE MDS 2022: Treatment of mushroom poisoning :

 # Treatment of mushroom poisoning :

A. Atropine

B. Pilocarpine

C. Adrenaline

D. Quinidine

The correct answer is A. Atropine.

A mixture of signs and symptoms can occur with muscarinic poisoning from medications or mushrooms. Manifestations may vary even among persons who ingested mushrooms grown in the same patch and gathered at the same time. Confusion can occur if mushroom poisoning is attributed to a suspected species rather than to the toxin suggested by signs and symptoms. Accurate diagnosis depends on clinical suspicion and recognition of muscarinic manifestations, notably diaphoresis, salivation, bladder cramping, diarrhea, and difficulty with visual accommodation. Muscarinic toxicity due to medications necessitates an adjustment in drug dosage. In mushroom poisoning that produces primarily muscarinic effects, atropine is the treatment of choice. 

PGCEE MDS 2022: Collum angle is seen in:

 # Collum angle is seen in:

a) Class I bimaxillary protrusion

b) Class II div 1

c) Class II div 2 

d) Class III

The correct answer is C. Class II div 2.

The angle which is formed by the intersection of the long axes of the crown and root angulation is called Collum angle. It is decreased in Class II Div 2 cases. Due to this reason the crown appears to be lingual from the long axis of the roots in class II div 2 cases. Collum angle has been confused with interincisal angle. Interincisal angle is decreased in Class II div 1 and increased in class II div 2.

PGCEE MDS 2022 : Most suitable antiarrhythmic drug for counteracting ventricular extrasystoles due to digoxin toxicity

 # The most suitable antiarrhythmic drug for counteracting ventricular extrasystoles due to digoxin toxicity is :

A. Lignocaine

B. Quinidine

C. Verapamil

D. Amiodarone

The correct answer is A. Lignocaine.

The primary treatment of digoxin toxicity is digoxin immune fab, which is an antibody made up of anti-digoxin immunoglobulin fragments. This antidote has been shown to be highly effective in treating life-threatening signs of digoxin toxicity such as hyperkalemia, hemodynamic instability, and arrhythmias. Fab dose can be determined by two different methods. First method is based on the amount of digoxin ingested whereas the second method is based on the serum digoxin concentration and the weight of the person.

Other treatment that may be used to treat life-threatening arrhythmias until Fab is acquired are magnesium, phenytoin, and lidocaine. Magnesium suppresses digoxin-induced ventricular arrhythmias while phenytoin and lidocaine suppresses digoxin-induced ventricular automaticity and delay afterdepolarizations without depressing AV conduction. In the case of an abnormally slow heart rate (bradyarrhythmias), Atropine, catecholamines (isoprenaline or salbutamol), and/or temporary cardiac pacing can be used.

USES OF LIDOCAINE

Lidocaine is safe if given by slow i.v. injection; is used to suppress VT and prevent VF. It is ineffective in atrial arrhythmias. Because of rapidly developing and titratable action it is a good drug in the emergency setting, e.g. arrhythmias following acute MI or during cardiac surgery. In acute MI, i.v. infusion of lidocaine can prevent VF, but a metaanalysis has shown that it fails to improve survival; may even increase short term mortality. Therefore, lidocaine is no longer administered prophylactically to all MI patients, but may be used in selected cases, and to treat ventricular arrhythmias when they occur. Efficacy of lidocaine in chronic ventricular arrhythmia is poor, but it suppresses VT due to digitalis toxicity, for which it is used because it does not worsen A-V block.