Gene therapy targeting the germ-line is:

 # Gene therapy targeting the germ-line is:

A. Heritable

B. Non heritable

C. Sometimes heritable

D. Unrelated to heritability

The correct answer is: A. Heritable

Germ-line gene therapy involves modifying DNA in germ cells (sperm, ova, or their precursors), which integrate into the genome and are transmitted to future generations, making the genetic changes heritable. This contrasts with somatic gene therapy, which targets non-reproductive cells and is non-heritable (option B). Option C is incorrect as heritability is inherent to germ-line targeting, and option D is irrelevant since heritability is the defining feature. Ethical and regulatory concerns limit germ-line therapy in humans, but the biological principle remains clear.

Raw erythematous areas with bleeding spots on a boy with juvenile diabetes mellitus

 # A 9 year old boy visited OPD for soreness in the mouth. He had history of juvenile diabetes mellitus and was on insulin therapy. On intraoral examination, a large white scrapable lesion was noted on the soft palate. Raw erythematous areas with bleeding spots were seen after scraping the lesion. What is the most likely diagnosis to be?

A. Diphtheria

B. Oral Thrush

C. White Spongy Nevus

D. Vincent’s stomatitis

E. Chronic Hyperplastic Candidiasis

The correct answer is B. Oral Thrush

Oral thrush (pseudomembranous candidiasis) is the most likely diagnosis, characterized by white, creamy plaques on mucosal surfaces like the soft palate that scrape off easily, revealing underlying erythematous, raw tissue prone to bleeding—directly matching the presentation. Juvenile diabetes mellitus predisposes to this via hyperglycemia impairing immune response and promoting Candida albicans overgrowth, common in children on insulin. Diagnosis is clinical, confirmed by microscopy if needed (hyphae in KOH prep). Treatment involves topical antifungals (e.g., nystatin suspension) and glycemic control; systemic options if refractory. Other options are less fitting: diphtheria involves adherent gray membranes with systemic toxicity; white spongy nevus is non-scrapable and hereditary; Vincent’s stomatitis targets interdental gingiva with necrosis; chronic hyperplastic candidiasis forms adherent, non-scrapable plaques.

Which of the following is an accessory cusp found on a mandibular molar?

 # Which of the following is an accessory cusp found on a mandibular molar?

A. Protostylid

B. Cusp of Carabelli

C. Dens Evaginatus

D. Paramolar cusp

The correct answer is A. Protostylid

The protostylid is a supernumerary accessory cusp located on the mesiobuccal surface of mandibular molars, often appearing as a pit, groove, or distinct tubercle that can vary in expression from mild to pronounced. In contrast, the cusp of Carabelli (option B) is an accessory feature on the mesiolingual surface of maxillary first molars; dens evaginatus (option C) typically presents as an occlusal tubercle on premolars (especially mandibular second premolars), though it can rarely affect molars; and the paramolar cusp (option D), also known as Bolk's cusp, is primarily an extra tubercle on the buccal surface of maxillary molars. 

Three days after the onset of myocardial infarction which enzyme level has the best predictive value?

 # Three days after the onset of myocardial infarction which enzyme level has the best predictive value?

A. Serum CPK

B. Serum LDH

C. Serum SGOT

D. Serum SGPT

The correct answer is B. Serum LDH

Lactate dehydrogenase (LDH) levels rise 12-24 hours after myocardial infarction (MI), peak at 48-72 hours (around day 3), and remain elevated for 7-14 days, providing the highest diagnostic sensitivity and predictive value for confirming MI at this late stage. In contrast, creatine phosphokinase (CPK) peaks early (12-24 hours) and normalizes by day 3, making it less useful then; serum glutamic-oxaloacetic transaminase (SGOT/AST) peaks at 24-48 hours and declines by day 3-4; and serum glutamic-pyruvic transaminase (SGPT/ALT) is primarily liver-specific with minimal cardiac relevance. The LDH-1 isoenzyme is particularly specific for cardiac tissue damage.