Salivary gland stone most commonly involves:

 # Salivary gland stone most commonly involves: 

a. sublingual gland 

b. Submandibular gland 

c. Parotid gland 

d. Lingual glands 

The correct answer is B. Submandibular gland. 

Sialoliths (salivary calculi or salivary stones) are calcified organic masses that form within the secretory system of the salivary glands. Although the exact mechanism of sialolith formation has not been established, it has been proposed that microcalculi are frequently formed in salivary ducts during periods of secretory inactivity. 

Sialoliths occur most commonly in the submandibular glands (80–90%), followed by the parotid (5–15%) and sublingual (2–5%) glands, and only very rarely occur in the minor salivary glands. Spontaneous secretion in the minor and sublingual salivary glands may provide continuous salivary flow, thereby preventing stasis.

The higher rate of sialolith formation in the submandibular glands is due to: (1) the torturous course of Wharton’s duct; (2) the higher calcium and phosphate levels of the secretions contained within; (3) the dependent position of the submandibular glands which leaves them prone to stasis; and (4) the increased mucoid nature of the secretion. In addition, since the submandibular and parotid glands’ secretion is dependent on nervous stimulation, in its absence, secretory inactivity increases the risk of stone development. 

Lab test for patient on warfarin

 # A patient on warfarin sodium following myocardial infarction reports for an oral surgical procedure. Which one of the following laboratory tests should be preferred to ascertain the fitness? 

a. Prothrombin time 

b. Torniquet time 

c. clotting time 

d. bleeding time 

The correct answer is A. Prothrombin time.

The PT and INR tests measure the time it takes for blood to clot by forming thrombin. They evaluate the extrinsic and common coagulation pathways, screening for the presence or absence of fibrinogen (F I), prothrombin (F II), and F V, F VII, and F X. The normal range of PT is approximately 11–13 seconds. Because of individual laboratory reagent variability and the desire to be able to reliably compare the PT from one laboratory with that from another, the PT test is commonly reported with the INR. The INR, introduced by the World Health Organization in 1983, is the ratio of PT that adjusts for the sensitivity of the thromboplastin reagents, such that a normal coagulation profile is reported as an INR of 1.0, and higher values indicate abnormal coagulation. Its most common use is to measure the effects of VKAs and reduction of the vitamin K–dependent F II, F VII, F IX, and F X. It is not effective for hemophilias A and B, since it does not measure F VIII or F IX. Although most patients on VKAs are monitored by monthly venous blood draws and laboratory analysis, the CoaguChek system allows Clinical Laboratory Improvements Amendments (CLIA)-waived point-of-care PT/INR testing of fingerstick blood in physicians’ and dentists’ offices.

Bremsstrahlung refers to:

 # Bremsstrahlung refers to: 

a. the primary source of X-rays from an X-ray tube 

b. Characteristic radiation emitted when an electron is displaced from the outer shell of a tungsten atom in the target 

c. the electromagnetic spectrum 

d. particulate radiation 

The correct answer is: A. a. the primary source of X-rays from an X-ray tube. 

BREMSSTRAHLUNG RADIATION: The sudden stopping or slowing of high-speed electrons by tungsten nuclei in the target produces bremsstrahlung photons, the primary source of radiation from an x-ray tube. (Bremsstrahlung means “braking radiation” in German.)

Multiple punched out radiolucencies is a feature of:

 # Multiple punched-out radiolucencies is a feature of: 

a. Multiple Myeloma 

b. Thalassemia 

c. Fibrous Dysplasia 

d. Ewing's Sarcoma 

The correct answer is A. Multiple myeloma.

The periphery of multiple myeloma lesions is well-defined but not corticated; it lacks any sign of bone reaction. The lesions have been described as appearing “punched out.” However, many appear ragged and even infiltrative. Some lesions have an oval or cystic shape. Untreated or aggressive areas of destruction may become confluent, giving the appearance of multilocularity.